Multiple approaches are needed to reduce hospital prescribing errors

Objective: This study was conducted to analyze and evaluate the prevalence of prescription errors, to optimize the medication effectiveness and patient safety and to encourage the rational prescribing practices. Method: sample of 250 prescriptions was randomly collected from outdoor hospital pharmacy (n=157) and from community pharmacy (n=93) and analyzed manually to estimate the prevalence of prescription errors. Results: Results calculated by using SPPS Version 23 and MS Excel 2013 are as follow; 41.4% prescription collected from outdoor hospital pharmacy presented significant prescribing errors while 54.7% in sample collected from community pharmacy. The prescriptions were segregated and errors were estimated using following parameters; dose, dosage form, dosing frequency, drug-drug interactions, spelling, and duplication of generic, therapy duration and unnecessary drugs. Conclusion: The prevalence of prescribing errors in sample of community pharmacy was 12.37% greater than found in prescriptions of hospital pharmacy. The prevalence of prescription errors can be reduced by physician education, using automated prescribing systems and immediate review of prescription by pharmacist before dispensing of prescription items to patients.

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Prescribing Errors With Direct Oral Anticoagulants and Their Impact on the Risk of Bleeding in Patients With Atrial Fibrillation

Journal of Cardiovascular Pharmacology and Therapeutics ◽

10.1177/10742484211019657 ◽

2021 ◽

pp. 107424842110196

Author(s):

Bruria Hirsh Raccah, PharmD, PhD ◽

Yevgeni Erlichman ◽

Arthur Pollak ◽

Ilan Matok ◽

Mordechai Muszkat

Keyword(s):

Atrial Fibrillation ◽

Major Bleeding ◽

Negative Impact ◽

Conditional Logistic Regression ◽

Oral Anticoagulants ◽

Direct Oral Anticoagulants ◽

Drug Dose ◽

Prescribing Errors ◽

Duration Of Treatment ◽

Inappropriate Treatment

Introduction: Anticoagulants are associated with significant harm when used in error, but there are limited data on potential harm of inappropriate treatment with direct oral anticoagulants (DOACs). We conducted a matched case-control study among atrial fibrillation (AF) patients admitting the hospital with a chronic treatment with DOACs, in order to assess factors associated with the risk of major bleeding. Methods: Patient data were documented using hospital’s computerized provider order entry system. Patients identified with major bleeding were defined as cases and were matched with controls based on the duration of treatment with DOACs and number of chronic medications. Appropriateness of prescribing was assessed based on the relevant clinical guidelines. Conditional logistic regression was used to evaluate the potential impact of safety-relevant prescribing errors with DOACs on major bleeding. Results: A total number of 509 eligible admissions were detected during the study period, including 64 cases of major bleeding and 445 controls. The prevalence of prescribing errors with DOACs was 33%. Most prevalent prescribing errors with DOACs were “drug dose too low” (16%) and “non-recommended combination of drugs” (11%). Safety-relevant prescribing errors with DOACs were associated with major bleeding [adjusted odds ratio (aOR) 2.17, 95% confidence interval (CI) 1.14-4.12]. Conclusion: Prescribers should be aware of the potential negative impact of prescribing errors with DOACs and understand the importance of proper prescribing and regular follow-up.

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