Medication Errors Identification: A Major Source of Evaluating Prescribing Errors in Liver Disease Patients | Chapter 03 | New Insights into Disease and Pathogen Research Vol. 2
Aim:
The aim of this study was to retrospectively review the patient profiles with
liver diseases in order to determine the frequency of medication errors among
patients with liver diseases.
Study Designed: Retrospective study
was performed.
Place and Duration of Study: Abbasi
Shaheed Hospital (ASH), Civil Hospital (CIVIL) and Dow University Hospital
(DUH) Karachi Pakistan, conducted from April 2014 to June 2014.
Methodology: The retrospective study
was conducted by evaluating 61 patient profiles. These patients were admitted
in three different hospitals of Karachi city mentioned above. Toxic hepatitis
or drug-induced liver injury comprises a spectrum of clinical diseases that
initiates with mild biochemical abnormalities and extends to acute liver
failure. In this study 61patient’s profiles were collected and evaluated. The
patients were aged 25 years and above. A quantitative analysis and
investigation of clinically significant drug-drug interactions, drug-disease
interactions, inappropriate medication, over dose and sub therapeutic dose has
been studied. Moreover these patients were suffering from either hepatitis B,
hepatitis C, hepatitis E, ascites, jaundice, liver abscess, hepatoma, chronic
liver disease (CLD), cirrhosis, hepatic encephalopathy or acute hepatitis.
Results: A total 257 medication
errors were observed, out of which 40% (n=102) were drug-drug interactions,
14.5% (n=37) were drug-disease interactions, 37.7% (n=97) were inappropriate
medications, 7.05% (n=18) were related to over-dose and 1.17% (n=3) were
identified as sub-therapeutic dose errors. The occurrence of different types of
medication errors was significantly different among the named hospitals.
Conclusion: It can be concluded that
a large number of medication errors in a minimal patient’s profiles were
observed. This shows a high percentage of irrational prescribing practice among
liver disease patients. Furthermore, there is a need to revise the proper
structure of hospital and clinical pharmacies. Additionally, the proper prescribing
patterns should be followed via employing computerized physician order entry
system (CPOE). The result of our study shows high number of medication errors.
The rate of medication errors can be minimized by inclusion of clinical
pharmacists in hospitals because pharmacist can play a vital role in the
identification and prevention of medication errors and can educate all health
care professionals with up-to-date information related to drugs. Implementation
of electronic based system like COPE system can be beneficial to minimize the
chances of errors and it is also essential to educate the patients about their
medications along with Staff orientation/development in order to reduce the
possibility of these errors.
Author(s) Details
Prof. Dr. Sumbul Shamim
Department of Pharmacology,
Faculty of Pharmaceutical Sciences, Dow College of Pharmacy, Dow University of
Health Sciences, Karachi, Sindh, Pakistan.
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