A 'dangerous duo': Opioids, anticoagulants involved in 40% of medication-related liability claims

Prescription and pills
Coverys found that antibiotic stewardship and barcoding are two areas where healthcare has found success in improving medication safety. (Getty/Gti337)

Opioids are involved in more medication-related liability claims than any other type of drug, according to a new analysis. 

Twenty-four percent of liability claims related to medication involved opioids, according to a report (PDF) from Boston-based medical liability insurer Coverys. Nearly half of those claims (46%) involved primary care providers, while 22% of claims were related to emergency departments or operating rooms. 

Coverys analyzed more than 10,000 closed medical liability claims filed against its clients between 2012 and 2016 for the report. Medication-related claims are listed as the fourth leading cause for liability claims overall, behind diagnostic-related claims, surgery-related claims and medical management-related claims.

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Though opioids were the leading drug associated with medication-related claims, Coverys said such medications were part of a "dangerous duo" with anticoagulants, which account for 16% of claims.

"When it comes to making patients safer, conversations between provider and patient and the routine activities surrounding medication are paramount," the report concluded. "It’s these 'everyday' or 'routine' decisions, interactions, and processes surrounding the medication episode of care that can and must be handled better." 

In addition, in 15% of cases, opioid claims involved allegations that physicians "behaved in an inappropriate way" toward a patient who was seeking the medication. 

RELATED: Nearly 1 in 4 Medicaid patients prescribed opioids in 2015 

The analysis offers five takeaways that providers can refer to in order to better manage risk and avoid medication-related claims: 

  1. The first and last points (ordering and medication monitoring and management) in a medication episode of care are most vulnerable to mistakes. These include prescribing errors and medication reconciliation issues, Coverys found.
  2. Medication error risk is greatest when it involves the youngest, oldest, smallest and heaviest patients. These patients may have specific dosing needs.
  3. Interventions must be supported and implemented. Top-down support for interventions to prevent medication errors is key to their success, according to Coverys.
  4. Different care settings pose different challenges to medication safety.
  5. Opioids and anticoagulants specifically require special care. As use of these medications becomes more common, so do complications, according to the report. 

Coverys also noted several areas where the healthcare industry has made progress in reducing medication errors that can lead to claims, including antibiotic stewardship, self-assessments and barcoding.