Medication Error Reporting: Underreporting and Acceptability of Smartphone Application for Reporting among Health Care Professionals in Perak, Malaysia

Abstract

Background and objectivesIn Malaysia, the national voluntary non-punitive Medication Error Reporting System (MER-S) has been available since 2009, with compiled reports indicating the underreporting of various medication errors (ME). This survey intends to determine the ME reporting practice among healthcare professionals and the acceptance of ME reporting by utilising smartphone application if it is available.DesignA cross-sectional survey was conducted for two months in 2017 among doctors and pharmacists in publicly funded healthcare facilities in Perak, Malaysia. The survey was distributed through various professional WhatsApp chat groups, and reminders were sent twice to the respondents.ResultsA total of 334 doctors and pharmacists responded to the survey; the majority were pharmacists (61.7%) with a median age (in years) of 32 (interquartile range (IQR) 29-36) and work experience (in years) of 7.5 years (IQR 5-11). The rate of respondents being aware of the MER-S and having encountered ME at the workplace was high, at 73.4% and 96.1%, respectively. However, only 44.8% reported using the system. The reason hindering them from reporting ME was primarily being in a busy and hectic work environment. Pharmacists were more likely to report ME compared to doctors (adjusted odds ratio (adj OR) 10.51; 95% Confidence interval (CI): 5.34, 20.6), especially pharmacists who had frequent encounters with ME at work (adj OR 2.84; 95% CI: 1.70, 4.81) and who perceived that ME can be handled well (adj OR 3.52; 95% CI: 1.93, 6.44). They were more likely to report ME. A majority (90.7%) had downloaded one or more digital medical applications to aid their work. The speed of Internet connectivity at the workplace was rated as “fast” or “good” among 136 (40.7%) respondents but among 130 (38.9%), it was “average.” The percentage of doctors and pharmacists that would report ME by utilising a smartphone application was 86.5% if one is available, and they preferred an application with a user-friendly interface, anonymity, and limited data-entry requirements.ConclusionDoctors and pharmacists were aware of MER-S and willing to report when they encountered ME. However, less than half of the respondents had used the system. With the primary concern of ME underreporting in a busy and hectic work environment, an alternative smartphone ME reporting application can be developed to complement the current MER-S considering that the respondents had positive responses to this method.

Practice, perceived barriers and motivating factors to medical-incident reporting: a cross-section survey of health care providers at Mbarara regional referral hospital, southwestern Uganda

“…Among the diagnostic errors, delayed diagnosis was high (84.8%), wrong diagnosis, inappropriate investigation and failure to use results as recorded (16.5, 63.9, and 69%, respectively) were listed. Also, failure to provide prophylactic treatment was observed among 69.6% of the healthcare providers; these results are in agreement with previous studies [10,[26][27][28]. This finding is consistent with a report in which medical errors where reportedly the main contributory factors towards the patients harm [29].…”

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“…Additionally, incenting those who report incidents, providing corrective action of the reported incidents, training of health workers about incidents and proper communication about the reported incidents with emphasis on prompt feedback were in agreement with previous studies [32,33]. Bivariate analysis indicated that three factors that strongly motivated health workers to [3,5,6,[24][25][26][27]. The barriers to MIR indicated that majority (80.9%) of the health workers indicated lack of knowledge.…”

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“…[ 3 ] This can result in under‐reporting of errors. [ 2,4–6 ] The degree to which voluntary incident reporting typically captures the true incidence of medication errors is difficult to ascertain and subject to high variability. [ 3,7 ] The types of errors most likely to go unreported in incident reporting systems are also unknown.…”