Introduction
Prescribing errors (PEs) resulting from inappropriate decision making or
writing process (1) can lead to medication-related morbidity and
mortality, placing pressure on healthcare services and incurring
substantial healthcare costs (2). Preventing or reducing the number of
PEs is recognized as a priority for improving in-hospital medication
safety, for example by institutions like the World Health Organization
(WHO) (2, 3).
Timely and structured evaluation of a patient’s medication list and use
is crucial for reducing medication-related patient harm. While
medication reviews has been shown to prevent hospital readmission (4, 5)
and decrease drug-related problems (6), they are labour- and
time-intensive and require the involvement of a competent ‘reviewer’,
other involved healthcare professionals, and the patient. It would
therefore be efficient to prioritise patients who would benefit from a
medication review. By identifying patients at risk, healthcare
professionals can allocate resources and interventions more efficiently,
targeting those who are more likely to experience medication-related
harm.
Patient factors, such as advanced age and impaired renal function, have
been identified as risk factors for PEs, as have setting-related factors
(admittance to specific clinical wards or treated by specific medical
specialties) and medication-related factors (use of specific medications
or medication groups, e.g., non-steroidal anti-inflammatory drugs,
methotrexate, and opioids) (7-16). Some of these stand-alone risk
factors have been combined into tools to predict or stratify patients at
risk of medication-related harm due to PEs (14, 17), but none of the
currently available prediction tools are optimal for this purpose (18).
In this study, we aimed to determine whether doctors can effectively
identify patients at risk of PEs and therefore at risk of
medication-related harm. To this end, a multidisciplinary in-hospital
pharmacotherapeutic stewardship (IPS) team assessed the prevalence of
PEs in patients on three hospital wards.