Legal issues in prescription writing: A study of two health institutions in Nigeria

Erhun, Wilson O.; Adekoya, Olalekan A; Erhun, Mercy O.; Bamgbade, O.

doi:10.1211/ijpp.17.03.0010

Cited by 7 publications

(10 citation statements)

References 7 publications

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“…None of the prescriptions stated the patient's contact information or weight. In a study from Nigeria, almost all prescriptions were deficient in patient's address but, in contrast to our results, almost all contained the patient's age [20]. In another Sudanese hospital study, the patient's full name was mentioned in 18.8% of prescriptions only [21].…”

Section: Discussioncontrasting

confidence: 98%

“…Sawalha et al showed that, in private practice in the West Bank, these details were present on all prescriptions [19]. However, almost all the prescriptions in our study had the prescriber's name and signature; this is consistent with the findings from a study in a teaching hospital in Nigeria where the prescriber's name was mentioned on 80% of prescriptions and the physician's signature was present on 96% [20]. In a study from Sudan, in contrast, the physician's name was mentioned in only 6.7% of prescriptions [21].…”

Section: Discussionsupporting

confidence: 91%

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Compliance with the guidelines of prescription writing in a central hospital in the West Bank

Yi¹,

Ibrahim²,

Mm³

et al. 2013

East Mediterr Health J

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This retrospective, cross-sectional study was carried out to evaluate the quality of 2208 outpatient prescriptions in a central hospital in the West Bank, Palestine. The physicians' handwriting was poorly readable or illegible in one-third of the prescriptions. The prescriber's name and signature and patient's name were mentioned in almost all orders whereas the patient's age was stated in 54.9%. The vast majority of physicians (95.5%) prescribed drugs using their trade (brand) names. Drug strength, quantity and dose/frequency were stated in 61.1%, 76% and 73.8% of prescriptions respectively. Only 33 prescriptions (1.5%) contained full directions for use for all drugs. Correlation analysis revealed that the presence of certain prescription elements was statistically significantly associated with the clinic of origin and the number of drugs prescribed. The overall poor legibility and incompleteness of the prescriptions is of concern. Respect des recommandations de rédaction d'ordonnance dans un hôpital central de CisjordanieRÉSUMÉ La présente étude rétrospective et transversale a été menée pour évaluer la qualité de 2208 ordonnances rédigées en consultation externe dans un hôpital central de Cisjordanie (Palestine). L'écriture des médecins était difficile à lire, voire illisible dans un tiers des cas. Le nom du médecin prescripteur, sa signature et le nom du patient étaient mentionnés sur presque toutes les ordonnances mais l'âge du patient n'était précisé que dans 54,9 % des cas. La grande majorité des médecins (95,5 %) avaient prescrit des médicaments en utilisant leur nom commercial (de marque). La concentration, la quantité, la posologie/la fréquence étaient indiquées dans 61,1 %, 76 % et 73,8 % des ordonnances, respectivement. Seules 33 ordonnances (1,5 %) donnaient des instructions complètes pour la prise de tous les médicaments prescrits. Une analyse de la corrélation a révélé que la présence de certains éléments de prescription était associée de manière statistiquement significative au centre de santé à l'origine de l'ordonnance et au nombre de médicaments prescrits. La mauvaise lisibilité globale et le caractère incomplet des ordonnances sont préoccupants.‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫التاسع‬ ‫املجلد‬ ‫التاسع‬ ‫العدد‬ 803

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Section: Discussioncontrasting

confidence: 98%

Section: Discussionsupporting

confidence: 91%

Compliance with the guidelines of prescription writing in a central hospital in the West Bank

Yi¹,

Ibrahim²,

Mm³

et al. 2013

East Mediterr Health J

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“…Prescribing errors are common among prescribers in Nigeria. [181920] This problem coupled with a low self-awareness of making prescribing errors, prompted our inclusion of interns perception of prescribing errors in the parameters assessed. The questionnaire included a 5-point Likert scale ranging from totally agree to totally disagree to determine respondents’ level of agreement with events that constitute a prescribing error [Appendix].…”

Section: Methodsmentioning

confidence: 99%

“…[1920] In the few studies examining the quality of prescribing by Nigerian medical practitioners, there appears to be a need to improve prescribing quality. However, it is not easy to change the prescribing habits of experienced doctors, thus there is the hope that educating junior doctors to prescribe according to a standard guideline may be a more effective intervention.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the knowledge and attitudes of intern doctors to medication prescribing errors in a Nigeria tertiary hospital

Ajemigbitse

Omole

Ezike

et al. 2014

J Basic Clin Pharma

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Context:Junior doctors are reported to make most of the prescribing errors in the hospital setting.Aims:The aim of the following study is to determine the knowledge intern doctors have about prescribing errors and circumstances contributing to making them.Settings and Design:A structured questionnaire was distributed to intern doctors in National Hospital Abuja Nigeria.Subjects and Methods:Respondents gave information about their experience with prescribing medicines, the extent to which they agreed with the definition of a clinically meaningful prescribing error and events that constituted such. Their experience with prescribing certain categories of medicines was also sought.Statistical Analysis Used:Data was analyzed with Statistical Package for the Social Sciences (SPSS) software version 17 (SPSS Inc Chicago, Ill, USA). Chi-squared analysis contrasted differences in proportions; P < 0.05 was considered to be statistically significant.Results:The response rate was 90.9% and 27 (90%) had <1 year of prescribing experience. 17 (56.7%) respondents totally agreed with the definition of a clinically meaningful prescribing error. Most common reasons for prescribing mistakes were a failure to check prescriptions with a reference source (14, 25.5%) and failure to check for adverse drug interactions (14, 25.5%). Omitting some essential information such as duration of therapy (13, 20%), patient age (14, 21.5%) and dosage errors (14, 21.5%) were the most common types of prescribing errors made. Respondents considered workload (23, 76.7%), multitasking (19, 63.3%), rushing (18, 60.0%) and tiredness/stress (16, 53.3%) as important factors contributing to prescribing errors. Interns were least confident prescribing antibiotics (12, 25.5%), opioid analgesics (12, 25.5%) cytotoxics (10, 21.3%) and antipsychotics (9, 19.1%) unsupervised.Conclusions:Respondents seemed to have a low awareness of making prescribing errors. Principles of rational prescribing and events that constitute prescribing errors should be taught in the practice setting.

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“…[234] Writing of prescriptions that lacked appropriate details and other errors were common though may not always result in actual adverse outcomes for patients. [567] However, when prescribers involved in potentially serious prescribing errors were interviewed, most stated that they were not aware of having made any errors in the past. [8] Such a lack of awareness may be because the prescribing, dispensing, monitoring and administration of medicines involve other persons of different professions in the continuum of patient care.…”

Section: Introductionmentioning

confidence: 99%

Effect of providing feedback and prescribing education on prescription writing: An intervention study

2016

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Background/Objective:Accurate medication prescribing important to avoid errors and ensure best possible outcomes. This is a report of assessment of the impact of providing feedback and educational intervention on prescribing error types and rates in routine practice.Methods:Doctors’ prescriptions from selected wards in two tertiary hospitals in central Nigeria were prospectively reviewed for a 6-month period and assessed for errors; grouped into six categories. Intervention was by providing feedback and educational outreach on the specialty/departmental level at one hospital while the other acted as the control. Chi-squared statistics was used to compare prescribing characteristics pre- and post-intervention.Results:At baseline, error rate was higher at the control site. At the intervention site, statistically significant reductions were obtained for errors involving omission of route of administration (P < 0.001), under dose (P = 0.012), dose adjustment in renal impairment (P = 0.019), ambiguous orders (P < 0.001) and drug/drug interaction (P < 0.001) post intervention though there was no change in mean error rate post intervention (P = 0.984). Though House Officers and Registrars wrote most prescriptions, highest reduction in prescribing error rates post intervention was by the registrars (0.93% to 0.29%, P < 0.001).Conclusion:Writing prescriptions that lacked essential details was common. Intervention resulted in modest changes. Routinely providing feedback and continuing prescriber education will likely sustain error reduction.

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Legal issues in prescription writing: A study of two health institutions in Nigeria

Abstract: The legal implications of non-compliance with WHO standards in prescription writing are discussed, with appropriate recommendations.

Cited by 7 publications

References 7 publications

Compliance with the guidelines of prescription writing in a central hospital in the West Bank

Compliance with the guidelines of prescription writing in a central hospital in the West Bank

Assessment of the knowledge and attitudes of intern doctors to medication prescribing errors in a Nigeria tertiary hospital

Effect of providing feedback and prescribing education on prescription writing: An intervention study

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