Abunales Judith L, OrdoñEz Jan Redmond V, Salandanan Saandra Beattina B, Ayran Charles Mandy G, Reyes-Abaya Rubina
Department of Clinical, Social, and Administrative Pharmacy, College of Pharmacy, University of the Philippines Manila.
Department of Pharmacy, Philippine General Hospital.
Acta Med Philipp. 2025 Jul 15;59(9):40-61. doi: 10.47895/amp.vi0.10684. eCollection 2025.
Medication errors pose substantial risks in hospitals, particularly concerning patient safety. These errors, occurring throughout the medication use process, are one of the most common causes of morbidity and mortality in clinical practice. In the Philippines, there is a lack of evidence on the prevalence and effects of medication errors, emphasizing the need for further investigation. This study evaluated the prescribing, transcribing, and monitoring errors among inpatients under the Pulmonary Medicine Service of the Department of Medicine in the Philippine General Hospital.
This cross-sectional retrospective records review used the total population purposive sampling technique to examine eligible charts of inpatients with asthma and/or COPD from August 1 to December 31, 2022. The frequency, type, and severity of medication errors were determined. Linear regression and Cox proportional hazards models were used to examine the relationship between patient-related factors and medication errors, and length of hospital stay and mortality.
Fifty (50) out of 226 medical records were processed and analyzed. Included patients were predominantly older male adults. More than twothirds of the patients were diagnosed with COPD while approximately one-fourth suffered from asthma. All patients were practicing polypharmacy and the vast majority presented with comorbidities. A total of 6,517 medication errors, predominantly prescribing errors (99.1%), were identified. Despite the high prevalence of medication errors, the majority were classified as "error, no harm" (98.8%), while only 1.17% were deemed as "error, harm." As the frequency of prescribing errors increases in the power of three (rough approximation of e), from 1 to 3 to 9 to 27, etc., the expected hospital stay increases by 2.078 days (p <0.001) (e.g., 3 = 9 errors with LOS of around 4 days); meanwhile, more severe transcribing errors increase the length of stay by 4.609 days (p = 0.034) All independent variables were noted to have a lack of significance and thus no meaningful patterns in the data related to patient mortality were identified, primarily due to the insufficient amount of observed mortality in the included sample.
All eligible patient charts had at least one medication error, with the majority being prescribing errors. Among the variables, prescribing errors significantly affected the length of stay, while severity of transcribing errors had a marginally significant effect. It is essential to develop comprehensive education and training initiatives and adopt a systematic approach to mitigate medication errors and promote patient safety.
用药错误在医院中构成重大风险，尤其关乎患者安全。这些错误发生在整个用药过程中，是临床实践中发病和死亡的最常见原因之一。在菲律宾，缺乏关于用药错误发生率及影响的证据，这凸显了进一步调查的必要性。本研究评估了菲律宾总医院内科肺病科住院患者的处方、转录和监测错误情况。
本横断面回顾性病历审查采用总体目的抽样技术，检查2022年8月1日至12月31日期间哮喘和/或慢性阻塞性肺疾病（COPD）住院患者的合格病历。确定用药错误的频率、类型和严重程度。使用线性回归和Cox比例风险模型来检查患者相关因素与用药错误、住院时间和死亡率之间的关系。
226份病历中有50份经过处理和分析。纳入的患者主要是老年男性成年人。超过三分之二的患者被诊断为COPD，约四分之一患有哮喘。所有患者都在使用多种药物，绝大多数患者伴有合并症。共识别出6517例用药错误，主要是处方错误（99.1%）。尽管用药错误发生率很高，但大多数被归类为“错误，无伤害”（98.8%），而只有1.17%被视为“错误，有伤害”。随着处方错误频率以三次方的幂增加（e的粗略近似值），从1增加到3再到9再到27等等，预期住院时间增加2.078天（p<0.001）（例如，3=9个错误，住院时间约为4天）；与此同时更严重的转录错误使住院时间增加4.609天（p=0.034）。所有自变量均无显著意义，因此在与患者死亡率相关的数据中未发现有意义的模式，主要原因是纳入样本中观察到的死亡数量不足。
所有合格患者病历至少有一处用药错误，大多数是处方错误。在这些变量中，处方错误显著影响住院时间，而转录错误的严重程度有轻微显著影响。制定全面的教育和培训举措并采用系统方法以减少用药错误并促进患者安全至关重要。
