Medication prescribing errors: data from seven Lebanese hospitals.
BACKGROUND
Medication prescribing errors are made all over the world. However, exact data about them are lacking in Lebanon. Our objective was to describe medication errors, including drug-drug interactions in medication orders given to patients admitted to Lebanese hospitals.


METHODS
A prospective study was carried out on 313 patients taken from seven Lebanese hospitals; 1826 medication orders were assessed for errors and 456 drug-drug interactions were found. Data was entered and analyzed on SPSS.


RESULTS
Around 40% of medication orders were judged to comprise at least one prescribing error, mainly no ordering of parameters monitoring (20%), unnecessary medication (9%), and no indication (7%). Errors occurred mainly in the pediatrics (50%) and internal medicine wards (40%). Having an infectious or gastrointestinal problem almost doubled the risk of medication prescribing error. Antiulcer agents, NSAIDs, antibiotics and steroidal agents were the medications mainly involved. Meanwhile, 12 adverse medication events were reported, with an odds ratio of association to a medication error of 7.4 (p = 0.004). As for drug-drug interaction (DDI), prescriptions comprised zero to 29 interactions, involving medications with low margin of safety such as acenocoumarol, amiodarone and valproate. Pharmacodynamic interactions were mainly found (60%). The majority of DDI were of high clinical significance and well documented (80%), with moderate (59%) to major (17%) severity.


CONCLUSIONS
These results highlight the urgency of an intervention to improve patients' outcomes and avoid deleterious impact of inadequate medication use in Lebanon. The presence of a clinical pharmacist, the inclusion of computerized systems and the application of drug management policies are suggested to decrease medication prescribing errors and enhance the physician attention to DDI.
Lebanese University, Faculty of Pharmacy, Clinical Pharmacy Department, Hadath Campus, Beirut, Lebanon.
Amal
A
Al-Hajje
Sanaa
S
Awada
Samar
S
Rachidi
Nazih Bou
NB
Chahine
Rania
R
Azar
Salam
S
Zein
Anna-Maria
AM
Hneine
Nadia
N
Dalloul
Georges
G
Sili
Pascale
P
Salameh
D016907:Adverse Drug Reaction Reporting Systems; D004347:Drug Interactions; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007861:Lebanon; D008508:Medication Errors / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012494:Sampling Studies