Samad Md Abdus, Sikdar K M Yasif Kayes, Munia Ashfia Tasnim, Patwary Farhan Tanvir, Sarkar Md Raihan, Rashed Md Rashidul Islam
Department of Pharmacy, Faculty of Pharmacy University of Dhaka Dhaka Bangladesh.
Department of Pharmacy, School of Pharmaceutical Sciences State University of Bangladesh Dhaka Bangladesh.
Health Sci Rep. 2024 Aug 12;7(8):e2302. doi: 10.1002/hsr2.2302. eCollection 2024 Aug.
Prescription errors can inadvertently compromise the effectiveness and increase the risk of adverse events. This study aims to compare prescription patterns and errors between government and private hospitals in Dhaka, Bangladesh, by evaluating the World Health Organization (WHO) prescription indicators, polypharmacy, and omission errors.
Between September 2021 and November 2021, a total of 399 prescriptions were collected from outpatient departments of various government and private hospitals from patients or their attendants. The data were analyzed using the statistical package STATA 15. Chi-square and Fisher's exact test were employed to determine associations ( < 0.05) among various types of categorical data.
Of the collected prescriptions, 48% ( = 192) were from government, while 52% ( = 207) were from private hospitals. The mean number of medicines per prescription was 5.16 for government and 5.87 for private hospitals. Generic names were absent (0%) in both types of hospitals. Antibiotics were present in 34.37% of prescriptions from government and 51.69% from private hospitals. Moreover, injection were found in 17.70% of government and 18.35% of private hospitals' prescriptions. Government hospitals adhered to 67.97% of the essential drug list, whereas private hospitals adhered to 80.42%. Associations between hospital types were observed in missing age, and comorbidities, while no association was found in inscription mistakes. Missing dates and signatures were also associated with hospital types. Polypharmacy was observed in 49.47% of government hospitals and 71.01% of private hospitals. Additionally, polypharmacy in females, pediatrics, geriatrics, and missing comorbidity were also associated with hospital types ( < 0.05).
Both government and private hospitals exhibited similar deviations from the WHO prescribing indicators. While government hospitals showed more omission errors, private hospitals exhibited higher rates of polypharmacy. Physicians in both types of hospitals should be vigilant about omission errors, maintain the WHO prescribing indicators, and minimize polypharmacy.
处方错误可能会无意中影响疗效并增加不良事件风险。本研究旨在通过评估世界卫生组织(WHO)处方指标、多重用药情况和漏开处方错误,比较孟加拉国达卡政府医院和私立医院的处方模式及错误情况。
在2021年9月至2021年11月期间,从各政府医院和私立医院的门诊部收集了患者或其陪护人员共计399张处方。使用统计软件STATA 15对数据进行分析。采用卡方检验和费舍尔精确检验来确定各类分类数据之间的关联(<0.05)。
在收集的处方中,48%(n = 192)来自政府医院,52%(n = 207)来自私立医院。政府医院每张处方的平均用药数量为5.16种,私立医院为5.87种。两类医院中均无通用名(0%)。政府医院34.37%的处方中有抗生素,私立医院为51.69%。此外,政府医院17.70%的处方和私立医院18.35%的处方中有注射剂。政府医院基本药物清单的遵循率为67.97%,私立医院为80.42%。在年龄缺失和合并症方面观察到医院类型之间存在关联,而在书写错误方面未发现关联。日期和签名缺失也与医院类型有关。政府医院49.47%存在多重用药情况,私立医院为71.01%。此外,女性、儿科、老年患者中的多重用药情况以及合并症缺失也与医院类型有关(<0.05)。
政府医院和私立医院在遵循WHO处方指标方面均存在类似偏差。政府医院漏开处方错误更多,而私立医院多重用药率更高。两类医院的医生都应警惕漏开处方错误,遵循WHO处方指标,并尽量减少多重用药情况。