PREVALENCE AND NATURE OF HANDWRITTEN OUTPATIENTS PRESCRIPTION ERRORS IN YEMEN

Adnan Aladhal, Obaid Alademi, *Khaled Alazazi and Mohammed Mansour

ABSTRACT

Objective: Prescription is an instruction written by a medical practitioner to pharmacist, which contains drug name, dose, frequency, directions for compounding, advices for drug consumption etc. The frequency of drug prescription errors is high in many countries of the world. The present study was performed to assess the current prescription writing trend for identifying frequent errors and proposing the ways by which these can be overcome. Unfortunately in Yemen although number of prescription errors is too high but there is not any study have been performed. Therefore, the aim of the present study was to indicate the prevalence and nature of handwritten outpatient prescriptions errors collected from the biggest educating hospital in Sana`a - Yemen. Methods: The prescribing errors were identified based on WHO guidelines for prescription writing and current guidance published in British National Formulary. The analysis of prescriptions was done manually with the help of Microsoft office Excel-2007. A total of 900 prescriptions were collected from August to January 2019. The type of error of omissions considered in this analysis includes all three important parts of prescriptions, that is superscription(Patient's information), inscription (Drug`s information), and subscription (Prescriber's information). The analyzed data were then subjected to simple descriptive analysis including frequency distribution, mean and finally expressed in percentage. Results: Most of the prescriptions evaluated did not follow the proper guidelines. Patient’s gender, directions for patients, dosage form and duration of therapy and drug generic name were missed in more than 75% of prescriptions. Patient`s age, and illegal handwritten were missed in more than 70% of prescriptions. Medicine strength, prescribed date, prescribe signature and prescribed name were missed in more than 60% of prescriptions. The most common type of superscription error of omissions was found to be gender (86.56%), age (72.11%) and name of the patient (7.11%). The highest inscription error of omissions was incomplete on direction for use in 81% of total prescription following 80% of prescriptions omitted the dosage forms of prescribed drugs, (78%) of prescriptions were not having the information on dose and duration of therapy, missing the strength of medicine in (62%) of total prescription and (31%) incomplete information on drug frequency. It was also found that more than 70% of prescriptions had illegible handwriting, (69%) of prescriptions omitted the prescriber's signature, 60% of prescriptions omitted the date of prescription and (43%) of prescriptions omitted the prescriber`s name of total prescriptions. Most drugs in the prescription were written by trade name (52%) which equal (69%) from the total of prescription errors where (27%) of the medicines were written by generic name. Conclusion: We conclude from this study that the handwritten prescriptions for outpatients were associated with significant frequency of minor and major prescription error of omissions. These serious prescription errors are the major cause of patient incompliance, cost of therapy, drug adverse reactions and ultimately the patient morbidity and mortality. Therefore, the study suggests the prescriber has to be more professional, cared, focused and concentrated during writing prescription for the outpatients. Implementation of computerized order entry system and participation of pharmacists at all points of medication process may also substantially improve prescription-writing trend.

Keywords: Outpatient Prescription; Prescription error, Handwritten error, WHO Standards; BNF, Yemen.