Comparative analysis of prescription patterns and errors in government versus private hospitals in Dhaka: A cross-sectional study.

Abstract

Prescription errors can inadvertently compromise the effectiveness and increase the risk of adverse events. This study aims to compare prescription patterns and errors between government and private hospitals in Dhaka, Bangladesh, by evaluating the World Health Organization (WHO) prescription indicators, polypharmacy, and omission errors. Between September 2021 and November 2021, a total of 399 prescriptions were collected from outpatient departments of various government and private hospitals from patients or their attendants. The data were analyzed using the statistical package STATA 15. Chi-square and Fisher's exact test were employed to determine associations (p < 0.05) among various types of categorical data. Of the collected prescriptions, 48% (n = 192) were from government, while 52% (n = 207) were from private hospitals. The mean number of medicines per prescription was 5.16 for government and 5.87 for private hospitals. Generic names were absent (0%) in both types of hospitals. Antibiotics were present in 34.37% of prescriptions from government and 51.69% from private hospitals. Moreover, injection were found in 17.70% of government and 18.35% of private hospitals' prescriptions. Government hospitals adhered to 67.97% of the essential drug list, whereas private hospitals adhered to 80.42%. Associations between hospital types were observed in missing age, and comorbidities, while no association was found in inscription mistakes. Missing dates and signatures were also associated with hospital types. Polypharmacy was observed in 49.47% of government hospitals and 71.01% of private hospitals. Additionally, polypharmacy in females, pediatrics, geriatrics, and missing comorbidity were also associated with hospital types (p < 0.05). Both government and private hospitals exhibited similar deviations from the WHO prescribing indicators. While government hospitals showed more omission errors, private hospitals exhibited higher rates of polypharmacy. Physicians in both types of hospitals should be vigilant about omission errors, maintain the WHO prescribing indicators, and minimize polypharmacy.