Prescribing errors among adult patients in a large tertiary care system in Saudi Arabia

Abstract

Background: Multiple studies have investigated medication errors in hospitals in Saudi Arabia; however, prevalence data on prescribing errors and associated factors remains uncertain.

Objective: Assess the prevalence, type, severity, and factors associated with prescribing errors.

Design: Retrospective database review.

Setting: Large tertiary care setting in Riyadh.

Patients and methods: We described and analyzed data related to prescribing errors in adults (>14 years of age) from the Medication Error Electronic Report Forms database for the two-year period from January 2017 to December 2018.

Main outcome measure: The prevalence of prescribing errors and associated factors among adult patients.

Sample size: 315 166 prescriptions screened.

Results: Of the total number of inpatient and outpatient prescriptions screened, 4934 prescribing errors were identified for a prevalence of 1.56%. The most prevalent types of prescribing errors were improper dose (n=1516; 30.7%) and frequency (n=987; 20.0%). Two-thirds of prescribing errors did not cause any harm to patients. Most prescribing errors were made by medical residents (n=2577; 52%) followed by specialists (n=1629; 33%). Prescribing errors were associated with a lack of documenting clinical information (adjusted odds ratio: 14.1; 95% CI 7.7-16.8, P<.001) and prescribing anti-infective medications (adjusted odds ratio 2.9; 95% CI 1.3-5.7, P<.01).

Conclusion: Inadequate documentation in electronic health records and prescribing of anti-infective medications were the most common factors for predicting prescribing errors. Future studies should focus on testing innovative measures to control these factors and their impact on minimizing prescribing errors.

Limitations: Polypharmacy was not considered; the data are from a single healthcare system.

Conflict of interest: None.

Figure 1.. Selection of medication prescriptions for prescribing errors.

Figure 2.. The most common anti-infective medications associated with prescribing errors.

Figure 3.. The most common medications involved in prescribing errors.