Medication Error Disclosure and Attitudes to Reporting by Healthcare Professionals in a Sub-Saharan African Setting: A Survey in Uganda

Abstract

BackgroundMedication errors (MEs) are largely under-reported, which undermines quality improvement and medication risk management in healthcare.ObjectivesTo assess attitudes of Ugandan healthcare professionals (HCPs) towards ME reporting, and identify characteristics of HCPs who endorsed integration of ME and adverse drug reaction (ADR) reporting, valued patient involvement in ME reporting, disclosed having ever made potentially harmful MEs, or observed possibly harmful MEs committed by other HCPs.MethodsHealthcare professionals self-completed a questionnaire on their attitudes towards the occurrence and reporting of MEs in purposively selected Ugandan health facilities (public/private) including the national referral and six regional referral hospitals representative of all regions.ResultsResponse rate was 67 % (1345/2000). Most HCPs (91 %; 1174/1289) approved a national ME reporting system for Uganda and 58 % (734/1261) endorsed integration of ME and ADR reporting. Two-thirds (65 %; 819/1267) of HCPs valued patient involvement in ME reporting, one-fifth (18 %; 235/1310) disclosed that they had ever made potentially harmful MEs, while two-fifths (41 %; 542/1323) had ever identified possibly harmful MEs committed by other HCPs. Endorsing patient involvement in ME reporting was more likely by HCPs who valued root-cause analysis and reporting of both actual and potential MEs, or who conceded inadequate communication and lack of time. Self-disclosure of having ever committed potentially harmful MEs was more likely with the need for confidentiality, working in stressful conditions, and willingness to report ADRs. Identifying possibly harmful MEs committed by other HCPs was more likely by non-nurses and those who reported blame culture, stressful conditions, ever encountered a fatal ADR, or attachment to hospital-level health facility.ConclusionA non-punitive healthcare environment and patient involvement may promote ME disclosure and reporting in Uganda and possibly other African countries.

The Burden of Adverse Drug Reactions Due to Artemisinin-Based Antimalarial Treatment in Selected Ugandan Health Facilities: An Active Follow-Up Study

“…The culture of documenting patient history and all that happens during the course of treatment is a challenge in Uganda, more so in an outpatient setting. There were many missed opportunities to capture medication errors as practitioners fear to implicate themselves, as some Ugandan researchers established [ 52 ]. In three cases, underdosing was seen for intravenous artesunate, a practice that could potentially contribute to antimicrobial drug resistance.…”

Extensive antibiotic prescription rate among hospitalized patients in Uganda: but with frequent missed-dose days

“…Involving patients and caregivers in safer healthcare has been encouraged by Ugandan HCPs who endorsed patient participation in the reporting of medication errors. 42 …”

Prevalence of Medication Errors and the Associated Factors: A Prospective Observational Study Among Cancer Patients at Mbarara Regional Referral Hospital

“…8 In Uganda, 18% of health care professionals disclosed having made medication errors while treating patients. 9 Medication errors are therefore a common occurrence among inpatient and outpatient encounters. There has been no similar research conducted in the study area on incidence of medication errors and specifically data about cancer-related medication errors.…”