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Prescribing errors in pediatric outpatient department at a tertiary care hospital in Malaysia
1Department of Pharmacy, Hospital Tengku Ampuan Rahimah, Jalan Langat, 41200, Klang, Selangor Darul Ehsan, Malaysia. jianlynn83@yahoo.com.
Insights
Prescribing errors in pediatric outpatient departments are common, with ambiguous prescriptions and incorrect dosages being frequent issues. Prescriber experience significantly impacts error rates, potentially affecting children
Area of Science:
- Pediatric pharmacology
- Medication safety
- Health services research
Background:
- Prescribing errors in children are prevalent due to individualized dosing.
- These errors pose significant risks to the pediatric population.
- Understanding contributing factors is crucial for improving medication safety.
Purpose of the Study:
- To determine the prevalence and types of prescribing errors in a Malaysian pediatric outpatient department.
- To identify factors contributing to these prescribing errors.
- To assess the potential clinical consequences of identified errors.
Main Methods:
- Prospective, cross-sectional observational study.
- Analysis of 250 new prescriptions (493 items) from a tertiary care hospital's pediatric outpatient clinic and pharmacy.
- Descriptive statistics and logistic regression were employed.
Main Results:
- 13% of prescriptions contained at least one error; 7.3% of all items were prescribed incorrectly.
- Ambiguous prescriptions (61.1%) and unrecommended dose regimens (13.9%) were the most common errors.
- Prescriptions written by house officers showed a significantly increased risk of error (OR 4.72).
Conclusions:
- Prescriber experience is a key factor influencing pediatric prescribing errors.
- A substantial proportion of errors were potentially significant or serious.
- Interventions targeting prescriber education and prescription clarity are needed to enhance patient safety.
Abstract:
Background Prescribing errors in children are common due to individualization of dosage regimen. It potentially has a great impact especially in this vulnerable population. Objective To determine the prevalence and common types of prescribing errors in a Malaysian pediatric outpatient department and to determine the factors contributing to prescribing errors. Setting Pediatric Outpatient Department and Outpatient Pharmacy at a tertiary care hospital in Malaysia. Method This is a prospective, cross sectional observational study where all new prescriptions received by the outpatient pharmacy from patients attending pediatric out-patient clinic were included for analysis. Descriptive statistics and logistic regression were used to analyze the data. Main outcome measure Frequency, types, potential clinical consequences and contributing factors of prescribing errors. Results Two hundred and fifty new prescriptions with 493 items were analyzed. There were 13 per 100 prescriptions with at least one prescribing error and 7.3% of the total items were prescribed incorrectly. The most common types of prescribing error were, an ambiguous prescription (61.1%) followed by an unrecommended dose regimen (13.9%). Logistic regression analysis showed that the risk of a prescribing error significantly increased when the prescription was written by a house officer (OR 4.72, p = 0.029). Errors were judged to be potentially non-significant (33.3%), significant (36.1%), or serious (30.6%). Conclusion The experience of prescribers is an important factor that contributes to prescribing errors in pediatrics. Many of the errors made were potentially serious and may impact on the patients' well-being.
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