Evaluation of prescribing medication errors in a pediatric outpatient pharmacy

Sulaiman, Khalid Al; Al-Jeraisy, Majed; Alharbi, Shmeylan; Alsulaihim, Ibrahim; AlMolaiki, Maha A; Alammari, Maha

doi:10.5455/ijmsph.2017.0718621092017

Cited by 5 publications

(9 citation statements)

References 12 publications

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“…These cases included serious drug-drug interactions, resulting from drugs being recommended in spite of contraindications or warnings to avoid combination. Our results were similar to those reported in other studies regarding the proportion of significant drug-drug interactions recorded in outpatient prescriptions, of about 1% [ 24 , 28 ]. Drug-drug interaction rates were usually higher in pediatric inpatients, but with fluctuations only of around 10% [ 8 , 9 , 29 ].…”

Section: Discussionsupporting

confidence: 92%

“…Male patients were higher in number than female patients, with a rate of about 1.2. This rate was similar to that in most DRP studies in children [ 5 , 23 , 24 ]. Patients younger than 6 years old accounted for about 80% of participants, and their mean age was 4.3 ± 3.6.…”

Section: Discussionsupporting

confidence: 89%

“…The most common DRPs were inappropriate dose selection and wrong time of dosing relative to meals, with 35.6% for both categories. In line with previous studies, inappropriate dose selection was common in children because of their specific pharmacokinetics, age groups, and weight [ 4 , 5 , 24 , 25 ]. It is therefore important to calculate dose based on the age and weight of each patient.…”

Section: Discussionsupporting

confidence: 71%

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Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam

Nguyen

Quach

et al. 2021

Healthcare

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Background: Our study was conducted to determine the prevalence of drug-related problems (DRPs) in outpatient prescriptions, the impact of DRPs on treatment efficacy, safety, and cost, and the determinants of DRPs in prescribing for pediatric outpatients in Vietnam. Methods: A retrospective cross-sectional study was conducted on pediatric outpatients at a pediatric hospital in Can Tho, Vietnam. DRPs were classified according to the Pharmaceutical Care Network Europe classification (PCNE) of 2020. The study determined prevalence of DRPs and their impacts on efficacy, safety, and cost. Multivariate regression was used to identify the determinants of DRPs. Results: The study included 4339 patients (mean age 4.3, 55.8% male), with a total of 3994 DRPs, averaging 0.92 DRP/prescription. The proportion of prescriptions with at least one DRP was 65.7%. DRPs included inappropriate drug selection (35.6%), wrong time of dosing relative to meals (35.6%), inappropriate dosage form (9.3%), inappropriate indication (7.1%), and drug-drug interactions (0.3%). The consensus of experts was average when evaluating each aspect of efficiency reduction, safety reduction, and treatment cost increase, with Fleiss’ coefficients of 0.558, 0.511, and 0.541, respectively (p < 0.001). Regarding prescriptions, 50.1% were assessed as reducing safety. The figures for increased costs and decreased treatment effectiveness were 29.0% and 23.9%, respectively. Patients who were ≤ 2 years old were more likely to have DRPs than patients aged 2 to 6 years old (OR = 0.696; 95% CI = 0.599–0.809) and patients aged over 6 years old (OR = 0.801; 95% CI = 0.672–0.955). Patients who had respiratory system disease were more likely to have DRPs than patients suffering from other diseases (OR = 0.715; 95% CI = 0.607–0.843). Patients with comorbidities were less likely to have DRPs than patients with no comorbidities (OR = 1.421; 95% CI = 1.219–1.655). Patients prescribed ≥ 5 drugs were more likely to have DRPs than patients who took fewer drugs (OR = 3.677; 95% CI = 2.907–4.650). Conclusion: The proportion of prescriptions in at least one DRP was quite high. Further studies should evaluate clinical significance and appropriate interventions, such as providing drug information and consulting doctors about DRPs.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 71%

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Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam

Nguyen

Quach

et al. 2021

Healthcare

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“…A significant improvement was observed in birth weight and correct patient diagnosis documentation, correction in dose statement, and in writing the dose unit and dose interval, but not the administration route. Alsulaiman et al 30 reported that missing diagnosis is the most common medication error. 30 However, in our study, we reported missing gestational age as the most common medication error.…”

Section: Discussionmentioning

confidence: 99%

“…Alsulaiman et al 30 reported that missing diagnosis is the most common medication error. 30 However, in our study, we reported missing gestational age as the most common medication error. Another observational finding reported by Myers et al 31 is a reduction in phone calls to the pharmacy after the introduction of a CPOE system with CDS.…”

Section: Discussionmentioning

confidence: 99%

Impact of Computerized Prescription on Medication Errors and Workflow Efficiency in Neonatal Intensive Care Units: A Quasi-Experimental Three-Phase Study

et al. 2020

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Background Neonates are highly vulnerable to preventable medication errors due to their extensive exposure to medications in the neonatal intensive care units (NICUs). These errors, which can be made by medical, nursing, or pharmacy personnel, are costly and can be life-threatening. This study aimed to investigate the newly developed computerized neonatal pharmaceutical health care system (NPHCS) in terms of its ability to (1) minimize neonatal medication prescription errors (NMPEs) and (2) improve workflow efficiency compared with the traditional manual prescribing approach. Methods A computerized neonatal medication prescription system was designed, developed, and tested successfully through a pilot clinical trial for over 6 months in 100 neonates. A three phase quasi-experimental study was then conducted using standardized monitoring checklists for the assessment of NMPEs before and after utilization of the developed prescribing system. Results The obtained result showed a high rate of NMPEs in both systems, especially for the antibiotic drug group. However, the use of newly developed NPHCS significantly improved workflow efficacy. The identified errors were significantly more common in the manual mode than in the computerized mode (158.8 vs. 55 per 100 medications). These errors were distributed among different categories, including the documentation of patient identity, birth weight, and gestational age, as well as statements of dose, unit, interval, and diagnosis. Analysis of variance across different categories showed a p-value of <0.05. Conclusion The use of the computerized NPHCS improved patient safety in NICUs by decreasing NMPEs. It also significantly reduced the time required for dose calculation, prescription generation, and electronic documentation of medical records, compared with the traditional handwritten approach.

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Assessment and analysis of outpatient medication errors related to pediatric prescriptions

Kassem

Saeed

El-Bassiouny

et al. 2021

Saudi Pharmaceutical Journal

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Background Medication errors are the errors that impact the efficacy and safety of the therapy. The impact of medication errors is higher for certain subjects, such as pediatrics, who require more attention. Hence, the current study aimed to investigate the types and frequency of outpatient medication errors of pediatric subjects related to different prescription types. Methods A cross-sectional study was carried in several community pharmacies to record the medication errors found in outpatient pediatric prescriptions by gathering data from the outpatient prescriptions besides direct counseling with the subjects and their parents. Many medical resources (disease and drug-related) were used for checking the different aspects of medication errors. The data collection process included a preprepared sheet containing several items representing the medication errors in addition to a counseling session. Data were expressed as percentages and compared through the Chi-square test for results of handwritten and computerized prescriptions. Results 752 outpatient pediatric prescriptions were recruited in the study as they involve medication errors. Among the highest percentage of medication errors was the absence of essential data in the prescription, such as diagnosis, age, and weight. The duration of the therapy and contraindication for some of the prescribed medications were among the highest recorded errors. Among the critical errors were the drug interaction and drug duplication that directly affect the drug's efficacy and safety. There was a significant difference between computerized and handwritten prescriptions regarding the number of medication errors related to each type. Conclusion Medication errors related to outpatient pediatric prescriptions vary from one to another prescription with predominant errors that influence the therapy's safety or efficacy. The role of patient counseling and prescription checking is critical for improving patient therapy.

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Evaluation of prescribing medication errors in a pediatric outpatient pharmacy

Cited by 5 publications

References 12 publications

Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam

Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam

Impact of Computerized Prescription on Medication Errors and Workflow Efficiency in Neonatal Intensive Care Units: A Quasi-Experimental Three-Phase Study

Assessment and analysis of outpatient medication errors related to pediatric prescriptions

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