Abstract
Background: Prescriptions written in daily medical practice are associated with increasing numbers of prescription writing errors. Both omission and commission errors are encountered and caused by prescribers of different cadres. Prescribing errors are associated with adverse drug events (ADEs), which are harmful to patients. This study aimed to determine the common prescription errors, the categories of prescribers who commit prescription errors, and the most prescribed drugs in the outpatient pharmacies in general practice at Kilimanjaro Christian Medical Centre (KCMC). Methods: A prospective cross-sectional descriptive study was conducted at KCMC, a referral and teaching university hospital. All prescription dispensed on 2 June 2017 from the hospital's 2 outpatient pharmacies were reviewed, and our analysis determined the different types of prescription errors. A form designed by the authors was used to collect data from the prescription forms. Results: A total of 242 prescriptions were studied, and the most common omission errors were missing patients' weight (n=231, 95.5%), missing patients' address (n=213, 88.0%), missing drug dosage (n=159, 67.1%), and commission errors were due to wrong drug strength (n=10, 2.0%). Intern doctors were leading in writing prescriptions with errors (n=352, 25.6%), followed by residents (n=199, 14.5%), registrar doctors (n=167, 12.1%), and specialists (n=45, 3.3%). The most commonly prescribed drugs were antibiotics (n=120, 17.3%), antihypertensives (n=81, 11.7%), and analgesics (n=86, 12.4%). Conclusion: There were significant prescription errors at the study site, hence an intervention is needed to improve skills of prescribers. Educational interventions can substantially contribute to minimising such errors. Initaiting programmes and short courses on prescription writing before medical internship at the health facility might also be helpful.
Highlights
Prescriptions are legal instructions written by medical practitioners that authorise patients to be issued medications by a pharmacist or dispenser
The prescription writing errors such as errors of omission related to prescriber (Patients name, Age, O/P Number, Date, Prescribers name, Prescribers signature, Clinic/Department, Weight, Diagnosis and illegible prescriptions); errors of omission related to drugs (Route of administration, Dose, Frequency, Strength, Dosage form, Duration/number of doses, Quantity to supply) and Errors of commission (Wrong strength, Wrong dosage form, Wrong drug name) were documented in a designed documentation form
A total of 581 medicines were prescribed in the 242 prescriptions, giving an average of 3.8 drugs per prescription that were collected at Kilimanjaro Christian Medical Centre outpatient pharmacies on the 2 June 2017
Summary
Prescriptions are legal instructions written by medical practitioners that authorise patients to be issued medications by a pharmacist or dispenser. Inappropriate prescription writing do not communicate clearly with the drug dispenser, as the results, there is occurrence of errors. Prescriptions written in daily medical practice are associated with increasing numbers of prescription writing errors. Both omission and commission errors are encountered and caused by prescribers of different cadres. This study aimed to determine the common prescription errors, the categories of prescribers who commit prescription errors, and the most prescribed drugs in the outpatient pharmacies in general practice at Kilimanjaro Christian Medical Centre (KCMC). Initaiting programmes and short courses on prescription writing before medical internship at the health facility might be helpful
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