Prevalence and pattern of prescription errors in a Nigerian kidney hospital

Abstract

Objectives: To determine (i) the prevalence and pattern of prescription errors in our Centre and, (ii) appraise pharmacists' intervention and correction of identified prescription errors. Design: A descriptive, single blinded cross-sectional study. Setting: Kidney Care Centre is a public Specialist hospital. The monthly patient load averages 60 General Outpatient cases and 17.4 in-patients. Participants: A total of 31 medical doctors (comprising of 2 Consultant Nephrologists, 15 Medical Officers, 14 House Officers), 40 nurses and 24 ward assistants participated in the study. One pharmacist runs the daily call schedule. Prescribers were blinded to the study. Prescriptions containing only galenicals were excluded. Interventions: An error detection mechanism was set up to identify and correct prescription errors. Life-threatening prescriptions were discussed with the Quality Assurance Team of the Centre who conveyed such errors to the prescriber without revealing the ongoing study. Main outcome measures: Prevalence of prescription errors, pattern of prescription errors, pharmacist's intervention. Results: A total of 2,660 (75.0%) combined prescription errors were found to have one form of error or the other; illegitimacy 1,388 (52.18%), omission 1,221(45.90%), wrong dose 51(1.92%) and no error of style was detected. Life-threatening errors were low (1.1-2.2%). Errors were found more commonly among junior doctors and nonmedical doctors. Only 56 (1.6%) of the errors were detected and corrected during the process of dispensing. Conclusion: Prescription errors related to illegitimacy and omissions were highly prevalent. There is a need to improve on patient-to-healthcare giver ratio. A medication quality assurance unit is needed in our hospitals.

Knowledge, practices and attitudes on antibiotics use in Cameroon: Self-medication and prescription survey among children, adolescents and adults in private pharmacies

“…The practice of self-medication is worldwide, more than 30% and up to 75% among adults in some sub-Saharan Africa countries [10–13, 15, 25,26] and between 5–50% in industrialized countries [1, 4, 5, 35]. These high percentages are comparable to that reported in our study with 38% of adults using antibiotics directly from pharmacies and without any physician’s prescription.…”

“…As antibiotics have been touted in certain communities as able to "treating everything" and their access is unregulated in developing countries, the abusive use of antibiotics is generally recognized [10–13,32] and bacterial resistance to antibiotics is frequently reported in these countries [1, 19, 24–26,31–34]. But the practice of how we produce, prescribe and use antibiotics remains unknown in many African countries.…”

“…In addition, antibiotics resistance is frequently identified and reported in Cameroon, and resistance to amoxicillin (55%) and cotrimoxazole (more than 65%) are the most frequently identified [24]. To date, many studies already have been undertaken to assess knowledge, attitudes and practices towards antibiotic use, the prevalence of self-medication and antibiotics prescribing in Africa [8, 9–15, 25, 26], but few evaluate the factors which could influence the prescription and self-medication of antibiotics among non-health care professionals in Africa [9]. These studies pointed out that the mothers with a higher score for knowledge of the antibiotics use and their hazards were less likely to give their children antibiotics without a prescription.…”

A study on prescribing errors in in-patients of a corporate tertiary care hospital in North India

“…When adjusted to criteria of this study, studies done on outpatients also report errors in prescription writing as the major contributor for errors. 8,12,[16][17][18][19] Also, this study is in agreement with illegibility as a cause of prescribing error (12.12%) with the studies of Ryan et al, (9.6%) and Mohan et al, (13.3%). 8,12 The error sub-type identified in this study to be the largest contributor of prescribing errors was mentioning strength for a drug which was not available in the market.…”

“…65% or greater. 12,13,[17][18][19] The reason for such stark contrast in studies done on in-patient's vs out-patients is that latter also look into the additional variables such as super inscription, diagnosis, anthropometric data, symbol Rx, duration of the treatment etc. which drives the prescribing error rate northwards.…”