Aim: The aim of this study was to retrospectively review the patient profiles with liver diseases in order to determine the frequency of medication errors among patients with liver diseases.
Study Designed: Retrospective study was performed.
Place and Duration of Study: Abbasi Shaheed Hospital (ASH), Civil Hospital (CIVIL) and Dow University Hospital (DUH) Karachi Pakistan, conducted from April 2014 to June 2014.
Methodology: The retrospective study was conducted by evaluating 61 patient profiles. These patients were admitted in three different hospitals of Karachi city mentioned above. Toxic hepatitis or drug-induced liver injury comprises a spectrum of clinical diseases that initiates with mild biochemical abnormalities and extends to acute liver failure. In this study 61patient’s profiles were collected and evaluated. The patients were aged 25 years and above. A quantitative analysis and investigation of clinically significant drug-drug interactions, drug-disease interactions, inappropriate medication, over dose and sub therapeutic dose has been studied. Moreover these patients were suffering from either hepatitis B, hepatitis C, hepatitis E, ascites, jaundice, liver abscess, hepatoma, chronic liver disease (CLD), cirrhosis, hepatic encephalopathy or acute hepatitis.
Results: A total 257 medication errors were observed, out of which 40% (n=102) were drug-drug interactions, 14.5% (n=37) were drug-disease interactions, 37.7% (n=97) were inappropriate medications, 7.05% (n=18) were related to over-dose and 1.17% (n=3) were identified as sub-therapeutic dose errors. The occurrence of different types of medication errors was significantly different among the named hospitals.
Conclusion: It can be concluded that a large number of medication errors in a minimal patient’s profiles were observed. This shows a high percentage of irrational prescribing practice among liver disease patients. Furthermore, there is a need to revise the proper structure of hospital and clinical pharmacies. Additionally, the proper prescribing patterns should be followed via employing computerized physician order entry system (CPOE). The result of our study shows high number of medication errors. The rate of medication errors can be minimized by inclusion of clinical pharmacists in hospitals because pharmacist can play a vital role in the identification and prevention of medication errors and can educate all health care professionals with up-to-date information related to drugs. Implementation of electronic based system like COPE system can be beneficial to minimize the chances of errors and it is also essential to educate the patients about their medications along with Staff orientation/development in order to reduce the possibility of these errors.
Prof. Dr. Sumbul Shamim
Department of Pharmacology, Faculty of Pharmaceutical Sciences, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Sindh, Pakistan.
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