Drug prescribing, prescription errors and prescription legibility at a primary healthcare center in a semi-urban community, South-South of Nigeria
https://doi.org/10.51412/psnnjp.2023.30
Keywords:
Amassoma, legibility of prescription, prescription errors, prescribing practiceAbstract
Background: Routine assessment of prescriptions written at health facilities is essential to determining rationality of drug use in a bid to improve health outcomes in patients receiving treatments. This study was aimed at assessing prescription pattern, errors, and legibility, including prescribing practice at Amassoma Comprehensive Health Center, Bayelsa State, South-South, Nigeria.
Methods: Total enumeration of appropriately documented 233 prescriptions of patients, who attended clinics at the study center from January 01 to December 31, 2020, was conducted. The prescriptions were assessed for errors, legibility and drug use. Also, prescribing practice at the center was assessed using selected WHO prescribing indicators. The SPSS v23.0 was employed for data analysis, and all data generated were presented in simple frequencies, percentages, and average values.
Results: Anti-infectives (457, 40.2%) were the most prescribed. A total of 2,392 errors were encountered, at 10.3 errors per prescription. Errors of omission related to drugs (1465, 61.2%) were the most observed, followed by errors of omission related to prescriber (623, 26.1%), and lastly, errors of commission (304, 12.7%). Meanwhile, missing information on quantity of medication to supply (1127, 99.2%) and prescriber's department (201, 86.3%) were the most noticeable among errors of omission related to drugs and prescribers, respectively, while drug-drug interactions (198, 17.4%) accounted for the most encountered of all errors of commission. Only a quarter (58, 24.9%) of all prescriptions seen were clearly legible, and none of the selected prescribing indicators was within the referenced standards.
Conclusion: Majority of the prescriptions contained mostly anti-infectives. Most were not completely legible and were fraught with several errors. In all, prescribing practice at the study center was suboptimal.
References
National Health Service (2023) Prescription: NHS Data Model and Dictionary. https://www.datadictionary.nhs.uk/classe s/prescription.html#:~:text=of%20SERV I C E % 2 0 R E Q U E S T . - ,A%20request%20for%20the%20dispen sing%20of%20one%20or%20more%20i temsAccessed:August 11, 2023
The Medicines Optimisation Team, Kingston Clinical Commissioning Group with the SWL Wound Care Sub-Group (2020) Top Tips for Prescribing Dressings. Approved by: NHS Kingston Medicines Committee, March 2018 and N H S R i c h m o n d C C G , J u l y 2 0 1 8 . https://www.kingstonformulary.nhs.uk/download /552/top-tips-for-prescribing-dressingsAccessed: January 25, 2023
British Pharmacological Society (n.d.) Ten P r i n c i p l e s o f G o o d P r e s c r i b i n g . https://www.bps.ac.uk/educatione n g a g e m e n t / t e a c h i n g - pharmacology/ten-principles-of-goodprescribing.comAccessed: January 15, 2023
de Vries TPG, Henning RH, Hogerzeil HV and Fresle DA (1994) Guide to Good Prescribing: A Practical Manual. World Health Organization Action Programme on Essential Drugs, Geneva. WHO/DAP/94.11., 1994.
Elliott RA, Camacho E, Jankovic D, Sculpher MJ, Faria R (2021) Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality Safety 30: 96–105. https://doi.org/10.1136/bmjqs-2019- 010206
Gadsby G (2022)Are prescription errors classified a s m e d i c a l n e g l i g e n c e ? https://www.gadsbywicks.co.uk/insights /medical- negligence/are-prescriptione r r o r s - c l a s s i fi e d - a s - m e d i c a l - negligence#:~:text=Consequently%2C% 20this%20means%20they%20are,the%2 0form%20from%20the%20patient Accessed: January 19, 2023
General Medical Council (2012) Investigating the prevalence and causes of prescribing errors in general practice. https://www.gmcuk.org/about/what-we-do-and-why/dataand-research/research-and-insightarchive/investigating-the-prevalenceand-causes-of- prescribing-errors-ingeneral-practiceAccessed: January 19, 2023
Aronson JK (2009) Medication errors: what they are, how they happen, and how to avoid them. Quarterly Journal of Medicine 102: 513–521. https://doi.org/10.1093/qjmed/hcp052
Velo GP and Minuz P (2009) Medication errors: prescribing faults and prescription errors. British Journal of Clinical Pharmacology, 67(6): 624–628. https://doi.org/10.1111/j.1365- 2125.2009.03425.x
Russo V, Orlando V, Monetti VM, Galimberti F, Casula M, Olmastroni E, Tragni E, Menditto E and EDU.RE.DRUG Group (2020) Geographical Variation in Medication Prescriptions: A Multiregional Drug-Utilization Study. Frontiers i n P h a r m a c o l o g y 11 : 4 1 . D o i : 10.3389/fphar.2020.00418
Vogenberg FR and Benjamin D (2011) The Medication-Use Process and the Importance of Mastering Fundamentals. Pharmacy and T h e r a p e u t i c s 3 6 ( 1 0 ) : 6 5 1 - 652.https://www.ncbi.nlm.nih.gov/pmc/a rticles/PMC3278147/pdf/ptj3610651.pd fAccessed: January 29, 2023
Shrestha R and Prajapati S (2019) Assessment of prescription pattern and prescription error in outpatient Department at Tertiary Care District H o s p i t a l , C e n t r a l N e p a l . J o u r n a l o f pharmaceutical policy and practice 12: 16. https://doi.org/10.1186/s40545-019- 0177-y
Vigneshwaran E, Sadiq MM and Prathima V (2016) Assessment of completeness and legibility of prescriptions received at community pharmacies. Journal of Health Research and Reviews 3: 72-76. DOI: 10.4103/2394- 2010.184242
World Health Organization Collaborating Centre for Drug Statistics Methodology (2019) Guidelines for ATC classification and DDD assignment 2020. Oslo, Norway, 2019.
Isah AO, Laing R, Quick J, Mabadeje AFB, Santoso B, Hogerzeil H, Ross-Degan D (2002) The Development of Reference Values for the WHO Health Facility Core Prescribing Indicators. West African Journal of Pharmacology and Drug R e s e a r c h 1 8 : 6 - 1 1 . D O I : 10.4314/wajpdr.v18i1.14718
Federal Ministry of Health (2020) Nigeria Essential Medicines List 2020 – 7th edition.
Buckley T, Cashin A, Stuart M, Browne G and Dunn S (2013) Nurse practitioner prescribing practices: The most frequently prescribed medications. Journal of Clinical Nursing 22. https://doi.org/10.1111/jocn.12086
Ganiyu KA, Kpokiri EE and Igbinovia KI (2014) Drug Utilization among Island Dwellers in Bayelsa State. Journal of Science and Practice of Pharmacy, 1 (1): 63-66.
Fuentes AV, Pineda MD and Venkata KCN (2018) Comprehension of Top 200 Prescribed Drugs in the US as a Resource for Pharmacy Teaching, Training and Practice. Pharmacy 6: 43. Doi:10.3390/pharmacy6020043
World Health Organization (2022) Anaemia. h t t p s : / / w w w . w h o . i n t / h e a l t h - topics/anaemia#tab=tab_1 Accessed: May 22, 2022
Sawyer W, Ordinioha B and Abuwa P (2013) Nutrition intervention program and childhood malnutrition: A comparative study of two rural riverine communities in Bayelsa State, Nigeria. Annal of Medical and Health Sciences Research 3: 422-6.
Protein ChallengeNG (2021) Bayelsa tops States with Malnourished Under-Five Children - Report. https://proteinchallengeng.com/bayelsatops- states-with-malnourished-underfive-children-report/Accessed: May 22, 2022
Adib SM, Nuwayhid I and Hamadeh GN (1995) Most common diseases treated in primary health care facilities in Lebanon. The Lebanese Medical Journal, 43(1): 17–22.
Ganiyu KA, Ekwueme MC and Ebiware-Otubo A (2020) Completeness and Legibility of Prescriptions and Prescribing Practice at Two Health Centres on Wilberforce Island, Bayelsa State, Nigeria. Journal of Basic and Social P h a r m a c y R e s e a r c h 1 ( 4 ) : 2 4 - 3 2 . https://www.jbspr.com/volume- 1-issue-42020- abstract-3/
Masnoon N, Shakib S, Kalisch-Ellett L and Caughey GE (2017) What is polypharmacy? A systematic review of definitions. BMC Geriatrics 17(1): 230. https://doi.org/10.1186/s12877-017- 0621-2
Ascierto PA and Marincola FM (2011) Combination therapy: the next opportunity and challenge of medicine. Journal of Translational Medicine 9: 115. https://doi.org/10.1186/1479- 5876-9-115
Ganiyu KA, Mac-Moses AO and Sounyo AA (2022) Drug prescribing and potential drug-drug interactions at the paediatric unit of a Secondary Health Facility in Southern-Ijaw Local Government Area, Niger Delta Region, Nigeria. West African Journal of Pharmacy 33 (1): 1 – 11.
Tamuno I and Fadare JO (2012) Drug prescription pattern in a Nigerian tertiary hospital. Tropical Journal of Pharmaceutical Research 11(1): 146–52. http://dx.doi.org/10.4314/tjpr.v11i1.19
Ganiyu KA, Owonaro PA and Adjerebe C (2016) Assessment of diseases and their managements at two health centers on Wilberforce Island in
Bayelsa State of Niger Delta Area, Nigeria. African Journal of Pharmaceutical Research and Development 8(2): 115-121.
Center for Infectious Disease Research and Policy (n.d.) Overuse and overprescribing of antibiotics. U n i v e r s i t y o f M i n n e s o t a . https://www.cidrap.umn.edu/asp/overuse - o v e r p r e s c r i b i n g - o f - antibiotics#:~:text=RisksAccessed: May 24, 2022
Best Practice Advocacy Centre New Zealand (2008) Why you should prescribe generically. B e s t P r a c t i c e J o u r n a l 1 4 . https://bpac.org.nz/BPJ/2008/June/gener ic.aspxAccessed: May 27, 2022
Hogerzeil HV (2004) The concept of essential medicines: lessons for rich countries. British M e d i c a l J o u r n a l 3 2 9 : 1 1 6 9 - 1 1 7 2 . https://doi.org/10.1136/bmj.329.7475.1169
Jasso L, LifshitzA,Arrieta O, Burgos R, Campillo C, Celis MÁ, Llata M, Domínguez J, Halabe J, Islas S, Moreno M, Plancarte R, Reyes-Sánchez A, Ruiz- Argüelles G, Soda A, Sotelo J and Verástegui E (2020) Importance of the list of essential medicines in medical prescription. Importancia del cuadro básico de medicamentos en la prescripción médica. Gaceta medica de M e x i c o 1 5 6 ( 6 ) : 5 9 8 – 5 9 9 . https://doi.org/10.24875/GMM.M21000 496
World Health Organization (2021) Essential Medicines. World Health Organization. https://www.afro.who.int/healthtopics/essential-medicines Accessed: May 29, 2022
Fox A (n.d.) Safer Prescribing Workbook Section 1 : P r e s c r i p t i o n W r i t i n g . https://www.uhs.nhs.uk/Media/suhtideal
/Doctors/SaferPrescribingWorkbook/Section1-Prescriptionwriting.pdf Accessed: May 29, 2022
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 The Nigerian Journal of Pharmacy
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.