Dispensing errors in community pharmacies in the United Arab Emirates: investigating incidence, types, severity, and causes

Abstract

Background: Medication dispensing is a fundamental function of community pharmacies, and errors that occur during the dispensing process are a major threat to patient safety. However, to date there has been no national study of medication dispensing errors in the United Arab Emirates (UAE).
 Objective: The study aimed to investigate the incidence, types, clinical significance, causes and predictors of medication dispensing errors.
 Methods: The study was conducted in randomly selected community pharmacies (n=350) across all regions of UAE over six months using a mixed-method approach, incorporating prospective disguised observation of dispensing errors and interviews with pharmacists regarding the causes of errors. A multidisciplinary committee, which included an otolaryngologist, a general practitioner and a clinical pharmacist, evaluated the severity of errors. SPSS (Version 26) was used for data analysis.
 Results: The overall rate of medication dispensing errors was 6.7% (n=30912/ 464222), of which 2.6% (n=12274/464222) were prescription-related errors and 4.1% (n= 18638/464222) pharmacist counselling errors. The most common type of prescription-related errors was wrong quantity (30.0%), whereas the most common pharmacist counselling error was wrong drug (32.1%). The majority of errors were caused by medicine replaced with near expire one (24.7%) followed by look-alike/sound-alike drugs (22.3%). The majority of errors were moderate (46.8%) and minor (44.5%); 8.7% were serious errors. Predictors of medication dispensing errors were: grade A pharmacies (dispensing  60 prescriptions a day (OR 2.1; 95%CI 1.4-3.6; p=0.03) and prescriptions containing ≥4 medication orders (OR 2.5; 95%CI 1.7-4.3; p=0.01).
 Conclusions: Medication dispensing errors are common in the UAE and our findings can be generalised and considered as a reference to launch training programmes on safe medication dispensing practice.

The Impact of International Nonproprietary Names Integration on Prescribing Reimbursement Medicines for Arterial Hypertension and Analysis of Medication Errors in Latvia

“…The overall rate of MEs was 0.6%. The error rate was lower than in the UAE (2.6%), Trinidad and Tobago (2.1%) and the USA (1.7%) but higher than in Denmark (1/10,000 cases) [ 21 , 22 , 23 , 24 ]. However, a statistical comparison with other studies’ results is not possible due to different methodology approaches, analysis of data types, varied healthcare professionals’ duties among countries and other factors.…”

Dispensing errors in Lebanese community pharmacies: incidence, types, underlying causes, and associated factors

“…They included giving incomplete/incorrect instructions, dispensing a wrong drug, a wrong dosage form, or a wrong dose, as well as omissions of additional warnings. 14 - 23 Moreover, as reported by other studies, the “dispensing error” rate was significantly lower than the “dispensing near-miss error” rate, and therefore the errors were detected and corrected while the medications were still in possession of the pharmacist. 18 , 19 , 21 This finding reflects the effectiveness of control systems adopted at the pharmacies, such as but not limited to double-checking and alerts embedded into the pharmacy computer system.…”

“…The data collection form was developed after a thorough review of the literature in this regard. 7 , 14 - 23 The final draft of the data collection form was pilot tested in ten pharmacies by ten students who were asked to fill this initial data collection form at the incidence of a dispensing error (for a total of ten dispensing errors). Feedbacks on the form were collected and the form was revised accordingly.…”

“…Dispensing a wrong drug, dispensing a wrong strength, dispensing a wrong dosage form, dispensing a wrong quantity, failure to supply the drug, and labeling errors (wrong drug name on the label; wrong strength on the label; wrong directions and warnings on the label; wrong quantity on the label; wrong patient name on the label) were among the reported types of dispensing errors. 14 - 23 Besides, the causes of dispensing errors were commonly attributed to drugs having similar names/packaging, the poor handwriting of physicians, heavy workloads, time pressures, lone worker, and frequent interruptions. 15 , 16 , 20 - 23…”

Medication errors analysis in Asia and Australia: A systematic review

“…There are 37 articles that discuss the incidence of MEs and their factors in Asia, where the articles consist of 9 articles from Southeast Asia [10][11][12][13][14][15][16][17][18] ; 3 articles from East Asia [19][20][21] ; 7 articles from South Asia [22][23][24][25][26][27][28] and 18 articles from West Asia [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] . A total of 2 articles discuss the incidence of MEs and their factors in Australia [47][48] .…”