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

Medication Errors in Saudi Arabian Hospital Settings: A Systematic Review

Background and Objectives: Medication errors significantly impact patient safety, potentially causing adverse drug events (ADEs), increasing morbidity and mortality and prolonging hospital stays. This systematic review aimed to identify common medication errors in Saudi hospitals, their contributing factors, and effective prevention strategies. Materials and Methods: Following PRISMA-P guidelines, a comprehensive review of the literature published after 2019 was conducted. Inclusion criteria focused on peer-reviewed articles in English addressing medication errors in Saudi hospitals. Exclusion criteria eliminated reviews, opinion pieces, and non-peer-reviewed sources. A narrative synthesis identified common themes, and a descriptive analysis organized the data. Results: Searches yielded 22 articles from Embase (n = 4), PubMed (n = 10), and Web of Science (n = 8). After removing duplicates and one review article, twelve studies remained. Hand-searching references added 16 more, totaling 28 articles. Of the 28 included studies, 20 (71.4%) reported the types of medication errors observed. Wrong dose and improper dose errors are among the most frequently reported across multiple studies, while prescribing errors remain consistently high, indicating a critical area for intervention. Although less frequent, omission errors still hold significance. Conclusions: This review emphasizes the importance of comprehensive, proactive approaches to preventing medication errors. Integrating evidence-based strategies, fostering a safety culture, and continuously monitoring and evaluating interventions can significantly enhance medication safety and improve patient outcomes in Saudi Arabian hospitals.

Patients' perceptions, experiences, and satisfaction with e-prescribing system: A cross-sectional study

INTRODUCTION

Electronic prescribing (e-prescribing) systems have the potential to increase the quality of care and reduce costs. Officially, since 22 December 2021, e-prescribing has been mandated in Iran. This study aimed to investigate the patients' perceptions about the e-prescribing system.

METHODS

A descriptive-analytic cross-sectional study was conducted in 2023. The study sample comprised 394 patients who were referred to the pharmacies of five teaching hospitals. The sample size was estimated using Cochran's formula. Data collection was performed using a researcher-made questionnaire. The data were analyzed using descriptive (mean, standard deviation, frequency, and percentage) and analytic (Pearson and Spearman correlation, One-way ANOVA, and two-sample t-test) statistics.

RESULTS

About 85 % of the patients were aware of the e-prescribing system, and 70 % of them preferred the e-prescribing. Almost 57 % of the patients believed that e-prescribing did not impact their medication adherence. The mean score of patients' satisfaction with e-prescribing, patients' attitude toward e-prescribing, and the impact of e-prescribing on patient care was 3.91 ± 0.046, 3.45 ± 0.028, and 3.10 ± 0.050 out of 5, respectively. There was a significant fair correlation between the impact of e-prescribing on patient care and patients' attitude towards e-prescribing. Additionally, there was a significant but poor correlation between patient satisfaction with the impact of e-prescribing on patient care and patients' attitude toward e-prescribing (P < 0.05).

CONCLUSION

The majority of the patients demonstrated awareness of the e-prescribing system and expressed a preference for electronic prescribing. Patients reported overall positive satisfaction, as well as relatively positive perceptions and experiences with the evaluated e-prescribing system. From the patients' perspective, receiving the e-prescribing tracking code through SMS was the most popular method for tracking their prescriptions. A greater focus on patient engagement and considering their requirements and needs in the system are crucial to improve the delivery of patient-centered care.

The Prevalence of High-Risk Prescribing of Oral Non-Steroidal Anti-Inflammatory Drugs in Primary Healthcare: A Single-Centre Retrospective Chart Review Study

The quality and safety of prescribed drugs can be assessed using prescribing safety indicators (PSIs). This study aimed to estimate the prevalence of PSIs of oral non-steroidal anti-inflammatory drugs (NSAIDs) at primary care clinics of a tertiary care hospital in Saudi Arabia and to identify the risk factors associated with positive PSIs for patients. In this retrospective chart review study, data from the medical records of 450 patients aged ≥18 years, who were prescribed oral NSAIDs, were reviewed and collected manually. Seven PSIs were chosen and defined as follows: prescription of an oral NSAID to any patient with a peptic ulcer; aged ≥75 years; aged ≥65 years with a glomerular filtration rate <60; heart failure; co-prescribed warfarin; co-prescribed aspirin or clopidogrel; or co-prescribed angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker and a diuretic. Patients with positive indicators are at risk of harm from high-risk prescribing. The overall period prevalence of PSIs is 153/450 (34%; 95% CI 29.60−38.39). The overall proportion of PSIs is 202/431 (46.9%; 95% CI 42.12−51.61). The most common safety indicators were for NSAIDs prescribed to patients with heart failure and patients aged ≥65 years with a glomerular filtration rate <60. The elderly and patients using polypharmacy are at increased risk of having at least one positive PSI (OR 5.22; 95% CI 3.32−8.21, p-value < 0.001 and OR 2.97; 95% CI 1.17−7.55, p-value 0.022, respectively). Patients at risk of harm from high-risk NSAID prescriptions are common in primary care. The elderly and patients on polypharmacy are at increased risk of having at least one positive PSI. Therefore, when NSAIDs are prescribed, it is recommended to weigh the benefits versus the risks for high-risk patients, such as the elderly and those with multiple-drug therapy.