Incidence of medication error associated with the use of beta-blockers in Pakistan

ABSTRACT

Medication errors [ME] are human errors, which are very frequent in cardiovascular patients and result in patient morbidity and mortality. This study was focused to evaluate the quality of prescriptions and to emphasize the placement of clinical pharmacist in health care team. This study was carried out in different outpatient settings of [in] Karachi, Pakistan. The study period was June'2011 till June'2012. Retrospective data was analyzed for the outpatients' prescription of beta blocker drugs. During the study, prescriptions [n=450] were collected from different outpatient settings of [in] Karachi, Pakistan. Prescription containing beta-blockers were analyzed for the essential elements to be mentioned in prescription. Drug-drug interactions were identified by the Micromedex.2.0 Drug-Reax database and severity of medication error was determined by NCCMERP Index. A total of 1627 medication errors were identified in 450 prescriptions. The most frequent error was not mentioning the patient's weight [95%], followed by missing diagnosis [79.4%] and drug-drug interactions [69.5%]. Twenty-two prescriptions were placed in the most severe category I [4.88%]. Average number of drugs per prescription was 4.76. Significant difference was observed [x[2]=52.418, p<0.05] using SPSS 19 for those prescription orders having more than 5 drugs with Beta-blockers. This indicates that the errors in prescription such as drug-drug interactions, wrong dose etc. was significantly increased with the number of drugs per prescription. Results showed that medication errors are very frequent in prescription written in outpatient setting of various hospitals and clinics in Karachi. This shows that the irrational prescribing is a common practice in developing countries. Placement of skilled pharmacist in the health care system is the only solution for avoidance of these medication related problems.