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The problem of prescribing errors in hospitals is “substantial” and not solely a problem of the most junior medical prescribers, “particularly for those errors most likely to cause significant patient harm”, a new pharmacist-led study has revealed.

Pharmacists in 20 UK hospitals reviewed 124,260 medication orders for 26,019 patients during seven prospectively selected days. The pharmacists identified errors in 8.8 per cent of medication orders. Doctors who were one and two years in training were roughly twice as likely to prescribe erroneously (odds ratio [OR] 2.13 and 2.23 respectively) as consultants.

Pharmacists were 16 per cent less likely to make errors on a medication order than consultants, although this did not reach statistical significance. Orders for certain drug classes were especially likely to contain serious errors: endocrine (OR 16.48 compared to gastrointestinal drugs), cardiovascular (OR 11.96), musculoskeletal and joint disease (OR 6.95), central nervous system (OR 6.69) and anti-infectives (OR 5.48).

Parenteral drugs were almost four times more likely (OR 3.66) to be associated with serious prescribing errors than oral drugs. For example, the risk of a serious prescribing error was almost 29 times (OR 28.63) higher for parenteral gastrointestinal drugs than those from this class that were not injected. (Drug Saf DOI 10.1007/s40264-015-0320-x)

 

Prescribing errors under scrutiny