Prescribing and dispensing practices in a public sector pediatric ward in D.I.Khan, Pakistan

ABSTRACT

Inappropriate prescribing practices are seen in many health facilities in developing countries. Medication errors, especially, in pediatric inpatients occur at similar rates as in adults but have three times the potential to cause harm. Antibiotic resistance secondary to poor prescription and dispensing practices are also a major concern for both doctors and patients. To evaluate the prescribing and dispensing practices in pedriatric inpatients at major public health facility and suggest strategies to over come irrational drug use. A prospective study was conducted on 50 children whose data were taken from a pediatric wards of District Headquarter Teaching Hospital D.I.Khan from April to May 2008. Medication errors were characterized by subtypes, ordering, dispensing, dose [over or under dose], adverse drug reactions, potential drug interactions, and irrational drug use, route, and frequency errors. Overall 249 medications were assessed and medication errors rate of 66% was observed. Error rates included overdose errors 27%, potential adverse drug and interactions [9%] and irrational drug use [6%]. Majority of errors [70%] occurred at the ordering stage and involved errors in dosing [42.4%], route [6.1%] and frequency [24.2%]. The most common medication error was in the dosing which ranged from normal dose to 10 times the actual dose required. Antibiotics and steroids were the most common drugs with medication errors. Overall 4 medications per prescription were recorded. Errors contributed by physician were 55%, nursing staff 41%, and pharmacy 4%. High medication error rate in public sector health care facility indicates potential health risk to the children. This problem can be easily solved by appointing a pharmacist in major public sector hospitals