Assessment of Prescription Errors in the Internal Medicine Department of a Tertiary Care Hospital in Nepal: A Cross-Sectional Study

  • Naresh Karki Lumbini Medical College and Teaching Hospital http://orcid.org/0000-0002-8788-6443
  • Kamal Kandel Lumbini Medical College and Teaching Hospital
  • Pravin Prasad Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Keywords: Error of omission, Medication error, Prescriptions, Tertiary hospital

Abstract

Introduction: Prescription errors are common problems in hospitals that lead to increase in morbidity, mortality and cost of treatments. They also reduce faiths towards healthcare providers. They are avoidable and their adverse outcome can be reduced if they are assessed and recognized earlier. This study was conducted to assess prescription errors occurred in tertiary care hospital Methods: A cross sectional study was conducted in Internal Medicine department of Lumbini Medical College for five months duration. Patients who prescribed at least one drug in prescription form were included. Results: Out of total patients, 39.5% had medication error. Among medication errors, 37.6% patients had error of omission. Among error of omission, dose of the drug was not mentioned in 26.1% patients. Category B (21.6%) of severity of medication error was the most common. Patients with one diagnosis less likely had medication errors comparing to the patients with more than one diagnosis (p = 0.0002). The tendency of making medication errors was higher among patients with polypharmacy (p < 0.001) and patients who prescribed Fixed-Dose Drug Combination (p < 0.001). Similarly, the tendency of making errors of omission was also higher among patients with more than one diagnosis (p = 0.0002), patients with polypharmacy (p < 0.001) and patients who prescribed Fixed-Dose Drug Combinations (p < 0.001). Conclusion: One-third of patients had medication errors. Among them, errors of omission were the most common. The collaborative program between doctors, clinical pharmacologists and hospital administration to minimize the occurrence of errors will be effective.  

Downloads

Download data is not yet available.

Author Biographies

Naresh Karki, Lumbini Medical College and Teaching Hospital

Assistant Professor,

Department of Pharmacology.

Kamal Kandel, Lumbini Medical College and Teaching Hospital

Lecturer,

Department of Pharmacology.

Pravin Prasad, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

Assistant Professor,

Department of Pharmacology.

References

World Health Organization. Medication Errors: Technical series on Safer Primary care. WHO: Geneva. Report number: ISBN 978-92-4-151164- 3, 2016. Available from: https://apps.who.int/iris/bitstream/handle/10665/252274/9789241511643eng.pdf;jsessionid=FDB1BE2683396D-2DA592F947714EBF5E?sequence=1

National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). About Medication Errors [Internet]. New York: NCC MERP; 2015 [cited 2020 July 8]. Available from: https://www.nccmerp.org/about-medication-errors

World Health Organization. WHO launches global effort to halve medication-related errors in 5 years [Internet]. Geneva: WHO;2017 [Cited 2020 July 10]. Available from:https://www.who.int/news-room/detail/29-03-2017-who-launches-global-effort-to-halve-medication-related-errors-in-5-years

Shrestha R, Prajapati S. Assessment of prescription pattern and prescription error in outpatient department at tertiary care district hospital, Central Nepal. Journal of Pharmaceutical Policy and Practice. 2019;12(0):16. DOI: https://doi.org/10.1186/s40545-019-0177-y

Velo GP, Minuz P. Medication errors: prescribing faults and prescription errors. Br J Clin Pharmacol. 2009;67(6):624-8. PMID: 19594530 DOI: https://doi.org/10.1111/j.1365-2125.2009.03425.x

Ansari M, Neupane D. Study on determination of errors in prescription writing: A semi-electronic perspective. Kathmandu University Medical Journal. 2009;7(27):238-41. PMID: 20071869 DOI: https://doi.org/10.3126/kumj.v7i3.2730

Sheikh D, Mateti UV, Kabekkodu S, Sanal T. Assessment of medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital. Future Journal of Pharmaceutical Sciences. 2017;3(0):60-64. DOI: http://dx.doi.org/10.1016/j.fjps.2017.03.001

Degu G, Tessema F. Biostatistics. University of Gondar, Ethiopia Public Health Training Initiative, The Carter Center. 2005. Available from: https://www.cartercenter.org/resources/pdfs/health/ephti/library/lecture_notes/env_health_science_students/ln_biostat_hss_final.pdf

Sapkota S, Pudasaini N, Singh C, GC S. Drug prescribing pattern and prescription error in elderly: A retrospective study of inpatient record. Asian Journal of Pharmaceutical and Clinical research. 2011;4(3):129-32. Available from: https://innovareacademics.in/journal/ajpcr/Vol4Issue3/450.pdf

Agency for Healthcare Research and Quality (AHRQ). Medications at transitions and clinical handoffs (MATCH) Toolkit for medication Reconciliation [Internet]. AHRQ: 5600 Fishers Lane, Rockville; 2012 [Cited 2019 July 20]. Available from: https://www.ahrq.gov/patient-safety/resources/match/matchtab6.html

Demeke B, Molla F, Assen A, Melkam W, Abrha S, Masresha B, et al. Evaluation of drugs utilization pattern using WHO prescribing indicators in Ayder Referral Hospital, Northern Ethiopia. International Journal of Pharma Sciences and Research. 2015;6(2):343-7. Available from: http://www.ijpsr.info/docs/IJPSR15-06-02-038.pdf

World Health Organization. Medication Safety in polypharmacy. WHO: Geneva. Report number: WHO/UHC/SDS/2019.11, 2019. Available from: https://apps.who.int/iris/handle/10665/325454

Laatikainen O, Snecks S, Turpeinen M. The risks and outcomes resulting from medication errors reported in the Finnish Tertiary care Units: A cross-sectional retrospective register study. Front Pharmacol. 2020;10(0):1571. PMID: 32009966 DOI: https://doi.org/10.3389/fphar.2019.01571

Shrestha S, Ramanath KV. Study and evaluation of medication errors in medicine and orthopedic wards of a Tertiary Care Hospital. British Journal of Pharmaceutical Research. 2015;7(3):183-95. DOI: https://doi.org/10.9734/BJPR/2015/18736

Patel S, Patel A, Patel V, Solanki N. Study of medication error in hospitalized patients in tertiary care hospital. Indian Journal of Pharmacy Practice. 2018;11(1):32-6. Available from: https://pdfs.semanticscholar.org/b457/93af15baf9a53391ba5d8241bcd50f15c2ff.pdf

Pote S, Tiwari P, D’cruz S. Medication prescribing errors in a public teaching hospital in India: A prospective study. Pharm Pract (Granada).2007;5(1):17-20. PMID: 25214913 DOI:https://doi.org/10.4321/s1886-36552007000100003

Paudel RS, Piyani RM, Shrestha S, Prajapati A, Adhikari B. Prescription errors and pharmacist intervention at outpatient pharmacy of Chitwan Medical College. Journal of Chitwan Medical College. 2015;5(12):20-24. DOI: https://doi.org/10.3126/jcmc.v5i2.13150

Boostani K, Noshad H, Farhood F, Rezaee H, Teimouri S, Entezari-Maleki T, et al. Detection and management of common medication errors in internal medicine wards: Impact on medication costs and patient care. Advanced Pharmaceutical Bulletin. 2019;9(1):174-79. PMID: 31011571 DOI: https://doi.org/10.15171/apb.2019.020

Published
2021-05-25
How to Cite
1.
Karki N, Kandel K, Prasad P. Assessment of Prescription Errors in the Internal Medicine Department of a Tertiary Care Hospital in Nepal: A Cross-Sectional Study. J Lumbini Med Coll [Internet]. 25May2021 [cited 28Jul.2021];9(1):8 pages. Available from: https://jlmc.edu.np/index.php/JLMC/article/view/414
Section
Original Research Article