Table 1.
Studies describing prescribing errors
| Country (Setting) | Type of study | Duration | Sample | Outcome | Reference |
|---|---|---|---|---|---|
| Israel (General hospital) | Prospective, prescriptions were reviewed in pharmacy. | 6 months | 14,385 prescriptions | 160 MEs were detected; 97 (60.6 %) were prescribing errors; Incorrect dosage (44) was the most common type. | [14] |
| Bahrain (Primary care) | Prospective, prescriptions were collected by pharmacists. | 2 weeks | 77,511 prescriptions | 7.7 % of prescriptions contained errors; Omission errors (93.6 %), Commission errors (6.3 %). | [15] |
| Iran (Teaching hospital) | Prospective, prescriptions from elderly patients were collected. | 4 months | 3000 prescriptions | 829 (27 %) patients received at least one inappropriate prescription; 746 (24 %) patients had at least one medicine prescribed in duplicate. | [22] |
| Bahrain (Primary care) | Prospective, prescriptions for infants were collected by pharmacists. | 2 weeks | 2282 prescriptions | 90.5 % of prescriptions contained errors; 74.5 % of medications contained drug errors; Dosing frequency was incorrectly written in 20.8 % and dose strength was incorrectly in 17.7 %. | [16] |
| Palestine (General hospital) | Prospective, all patients with creatinine clearance ≤59 ml/min were included, data were collected from patients’ files. | 4 months | 78 patients | 63 (80 %) patients were having at least one inappropriate medication; 1.5—fold greater than the recommended dose, poor knowledge of pharmacokinetics of prescribed drug. | [23] |
| Egypt (Teaching hospital, ICU) | Prospective, direct observation by pharmacist was conducted to record medication-related problems. | 1 year | 220 patients | 619 medication-related problems were detected in 213 patients; Incorrect dosing (22 %) was the most common errors in ICU. | [24] |
| Bahrain (Primary care) | Prospective, iron prescriptions for infants were collected and reviewed by pharmacist. | 2 weeks | 2,282 prescriptions | 159 prescriptions included iron preparation; 56 out of 159 were issued without dosage forms and duration of therapy. | [17] |
| Iran (Teaching hospital) | Prospective, drug order sheets in nephrology ward were reviewed by clinical pharmacist. | 4 months | 76 patients (818 medications) | 86 (10.5 %) prescribing errors were detected in 46 of the admissions; wrong frequency (37.2 %), wrong dose (19.8 %) and overdose(12.8 %) were the most common types of errors. | [18] |
| Saudi (Primary care) | Prospective, prescriptions were reviewed in public and private centres | NR | 600 prescriptions | 64 (72 %) physicians were classified as writing low-quality prescriptions | [25] |
| Saudi (Teaching hospital) | Prospective, medication charts and orders data collected by pharmacists | 1 month | 1582 medication order | 113 (7.1 %) prescribing errors were detected; Wrong strength 39 (35 %) followed by wrong dose frequency 26 (23 %). | [26] |
| Saudi (Primary care) | Prospective, all medication prescriptions were analysed. | 1 working day | 5299 prescriptions | 990 (18.7 %) prescribing errors identified; 8 (0.15 %) prescribing errors had serious effect on the patients. | [27] |
| Bahrain (Primary care) | Prospective, prescriptions issued by the residents were collected by pharmacists | 1 year | 2692 prescriptions | 2372 (88 %) prescriptions had errors; total number of errors was 7139; Incorrect dose and wrong dose frequency (24.7 %) of errors. | [19] |
| Israel (Teaching hospital) | Prospective, case–control study | 18 months | 274 patients | 137 MEs were identified; 63 (46 %) errors were prescribing. | [20] |
| Saudi (Teaching hospital) | Retrospective, all prescriptions obtained from pharmacy were analysed by physicians and pharmacists. | 1 year | 3796 prescriptions | 94 % of prescriptions had no quantity indicated; 90.7 % of prescriptions had incomplete instructions for patients. | [28] |
| Iran (Paediatric hospital) | Retrospective, hospital information-based study. | 6 months | 898 medical charts | Incomplete information in 74 % of medication orders; Time of drug administration not reported in 47.8 % of medical charts. | [29] |
| Israel (Teaching hospital, ED) | Retrospective, charts review was performed by two physicians for adult patients transferred by ambulance. | 1 year | 471 patient charts | 24 (12.7 %) of 188 patients receiving drugs in vehicle were subject to MEs; In ED 120 (36 %) of 332 patients were subject to MEs. | [30] |
| Saudi (Tertiary hospital, PICU & paediatric wards) | Retrospective of paediatric physicians medication orders. | 5 weeks | 2,380 medication orders | 1,333 MEs were reported; 1,051 (78.8 %) errors were potentially harmful; Incidence rate was 56 per 100 medication order; Dose errors were the highest incidence (22 %). | [21] |
| Saudi (General Hospital) | Medical records were reviewed for adult patients. | 2 years | 2627 patient files | 3963 MEs were identified; 60 % of patient files contained one error; 30 % of patient files contained two errors, and 3 errors or more found in 10 % of patient files. Wrong strength was reported in 914 patients (35 %). | [31] |
| Israel (Not applicable) | Questionnaire | NR | N/A | 18 % of doctor orders were written according to the hospital standard; 3 % of doctors and 25 % of nurses were the rate of compliance in ED. | [32] |
| Israel (Not applicable) | Structured questionnaire sent to active physicians to evaluate the rates and types MEs that they had encountered. | NR | 627 physicians | 470 (79 %) physician made an error in prescribing; 376 (63 %) physicians made more than one error; 94 (16 %) physicians made one error. | [33] |
| Saudi (Primary care) | Self—administered questionnaire designed to explore factors influencing prescribing. | NR | 87 physicians | 47 (54 %) physicians believed that limited knowledge of pharmacology is a main cause of prescribing errors; 65 % of physicians had not received training in drug prescribing; 34 % of physicians had consulted a pharmacist before drug prescribing. | [34] |
MEs: Medication Errors; NR: Not Reported, N/A: Not Available.