The Effect of Pharmacist-led Prescription Screening on Prescribing Errors in Outpatients Pharmacy, Rajavithi 2 (Rangsit) Hospital

Abstract

Background: Medication errors can occur at any point in the patient care process, including ordering, transcribing, dispensing, and administering medications, potentially resulting in patient harm. Among these, prescribing errors are widely recognized as key indicators for assessing the quality of care in hospitals, as they directly impact the effectiveness of treatment and patient safety. To address this issue, the Pharmacy Department implemented a prescription screening system aimed at preventing prescribing errors and enhancing medication safety. Objective: To determine the incidence of prescribing errors identified through pharmacist screening and to explore associated factors. Method: A retrospective descriptive study was conducted using outpatient prescription data from Rajavithi Hospital 2 (Rangsit) between November 2022 and December 2023. Result: A total of 19,053 prescriptions screened by pharmacists, 156 prescribing error events were identified across 145 prescriptions, incidence rate of 8.19 per 1,000 prescriptions. Most errors were categorized as severity level B (96.79%), meaning they did not reach the patient. The most common error types were unclear prescriptions (28.24%), duplicate prescribing (18.24%), and wrong direction (16.47%). The most frequently involved drug groups were musculoskeletal and joint disease medications (24.12%), immunological products and vaccines (21.18%), and cardiovascular medications (15.88%). Errors were predominantly found in prescriptions from the Family Medicine Department (67.31%). Pharmacist interventions were accepted by physicians in 97.44% of cases. A statistically significant association was found between a history of drug allergy and prescribing errors (OR = 1.87, 95%CI: 1.31, 2.67, p = .001). Conclusion: Prescription screening by a pharmacist could detect and prevent medication errors. Furthermore, prescription screening could reduce medication errors and ensure that patients receive the correct and safe drug.