title: The impact of preprinted prescription forms on medication prescribing errors in an ophthalmology clinic in northeast Thailand: a non-randomised interventional study.
abstract: OBJECTIVE
  To understand the incidence and types of medication prescribing errors in a low resource setting ophthalmology clinic and to determine the impact of a preprinted prescription based on the hospital formulary (FormularyScript) on medication prescribing errors.
  
  
  METHODS
  Non-randomised interventional study.
  
  
  METHODS
  Ophthalmology clinic in a teaching hospital in northeast Thailand.
  
  
  METHODS
  4349 handwritten prescriptions collected from October 2009 to December 2009, and 4146 FormularyScripts collected from February 2010 to May 2010.
  
  
  METHODS
  All prescriptions from the handwritten and FormularyScript groups were analysed for medication error rates by types (legibility, ambiguous, incomplete, abbreviation and accuracy) and subtypes (drug name, strength, which eye, route and dispensed amount).
  
  
  RESULTS
  Comparison of error rates in the two groups showed a 10-fold reduction in the overall error rate using FormularyScript (32.9%-3.5%, p<0.001). FormularyScripts were associated with statistically significant (p<0.001) decreases in the following error types: legibility (16.1%-0.1%), incomplete (16.1%-0.1%) and abbreviation (3.1%-0.3%). There was no statistically significant change in accuracy errors (0.8%-0.6%, p=0.21). Ambiguous errors increased with FormularyScripts (0.6%-2.5%, p<0.001), likely due to the introduction of new ways to make errors. Decreases were seen in all legibility, abbreviation and accuracy error subtypes, and four out of six incomplete error subtypes. There were statistically significant increases in both ambiguous error subtypes: which eye (0.3%-2.5%, p<0.001) and drug name (0.3%-0.6%, p=0.03).
  
  
  CONCLUSIONS
  In our study population, outpatient medication prescribing errors were common and primarily due to legibility and incomplete error types. A preprinted prescription form has the potential to decrease medication prescribing errors related to legibility, incomplete prescribing information and use of unacceptable abbreviations without changing the overall rate of accuracy errors. However, new error types can occur.
authors.affiliation: Department of Ophthalmology, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Thuss
authors.initials: T
authors.lastname: Sanguansak
authors.forename: Michael G
authors.initials: MG
authors.lastname: Morley
authors.forename: Yosanan
authors.initials: Y
authors.lastname: Yospaiboon
authors.forename: Alice
authors.initials: A
authors.lastname: Lorch
authors.forename: Bethany
authors.initials: B
authors.lastname: Hedt
authors.forename: Katharine
authors.initials: K
authors.lastname: Morley