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Prescribing Errors With Low-Molecular-Weight Heparins.

Marielle Slikkerveer1, Afke van de Plas1, Johanna H M Driessen

  • 1From the Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center.

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This summary is machine-generated.

Prescribing errors for low-molecular-weight heparins (LMWHs) affect 34% of patients, often due to incorrect dosing based on weight and kidney function. Medical wards show higher error rates for LMWH prophylaxis.

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Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Health Services Research

Background:

  • Low-molecular-weight heparins (LMWHs) are critical for preventing and treating venous thromboembolism (VTE).
  • Bleeding is a significant complication of LMWH therapy, directly related to dosage.
  • Accurate LMWH dosing requires consideration of VTE risk, bleeding risk, body weight, and renal function, making prescribing complex and error-prone.

Purpose of the Study:

  • To determine the frequency of in-hospital prescribing errors associated with low-molecular-weight heparins (LMWHs).
  • To identify the key factors contributing to LMWH prescribing errors.

Main Methods:

  • A cross-sectional study analyzed LMWH prescribing errors in 500 adult patients over four months.
  • Prescribing errors were defined as deviations from internal hospital guidelines.
  • Logistic regression was used to identify determinants of these errors.

Main Results:

  • A prescribing error was identified in 34% of patients receiving LMWHs.
  • The most common error (85%) involved incorrect dosage adjustment for body weight and/or renal function.
  • Prophylactic LMWH use in medical wards was linked to a higher incidence of prescribing errors compared to surgical wards.

Conclusions:

  • The study found a 34% LMWH prescribing error rate in a tertiary care hospital.
  • Prophylactic LMWH use on medical wards is a significant determinant of prescribing errors.
  • Interventions focusing on electronic recording of patient weight and enhancing physician awareness are recommended to reduce LMWH prescribing errors.