Factors contributing to the identification and prevention of incorrect drug prescribing errors in outpatient setting

Medication errors in prescribing are common and could lead to high morbidity and mortality. The objective of the current study was to explore factors that help pharmacists identify and thus prevent harm from incorrect drug prescribing errors in an ambulatory care setting.

At the King Faisal Specialist Hospital and Research Center, a tertiary care referral hospital in Riyadh, Saudi Arabia, medication error reports from the pharmacy are initiated by the pharmacist and reviewed by the quality control department and medication safety officer. This was a retrospective study in the hospital ambulatory care pharmacies including incorrect drug error reports from January 2011 until September 2012. Reports were reviewed by two pharmacists to ensure the accuracy of data classification. Factors contributing to the identification of incorrect drug prescribing errors were identified.

During the study period, a total of 2073 prescribing errors were included in the hospital Safety Reporting System. Incorrect drug prescribing errors identified by pharmacists comprised 203 reports (10%). Factors contributing to the identification of incorrect drug prescribing errors were: matching the drug with the indication for prescribing included in the prescription (34%), reviewing the patient's medication history (27%), patient counseling and review of medication history (9%), patient counseling during dispensing (8%), others (15%), and not specified by the reporter (7%).

Pharmacists reviewing and matching the indication for prescribing the prescribed drug and reviewing patient medication history before dispensing were the major factors (60%) found that allowed pharmacists to detect and thus prevent incorrect drug prescribing errors. Therefore, including the indication in the prescription as a mandatory field is important for patient safety.