Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Perceived causes of prescribing errors by physicians: A qualitative study

Basmah Al-Fageh¹, Hisham Aljadhey², Mansour A Mahmoud³ , Nouf Al-Fadel², Mohamed Azmi Hassali⁴, Bryony Dean Franklin⁵

¹King Saud University, Department of Clinical Pharmacy; ²Saudi Food and Drug Authority, Riyadh; ³Taibah University, Clinical and Hospital Pharmacy Department, College of Pharmacy, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia; ⁴Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; ⁵Centre for Medication Safety and Service Quality, UCL School of Pharmacy/Imperial College Healthcare NHS Trust, London, United Kingdom.

For correspondence:- Mansour Mahmoud Email: Mammm.99@gmail.com Tel:+966530187594

Accepted: 19 June 2018 Published: 28 July 2018

Citation: Al-Fageh B, Aljadhey H, Mahmoud MA, Al-Fadel N, Hassali MA, Franklin BD. Perceived causes of prescribing errors by physicians: A qualitative study. Trop J Pharm Res 2018; 17(7):1413-1422 doi: 10.4314/tjpr.v17i7.27

© 2018 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To explore physicians’ perceived causes of prescribing errors in Saudi hospitals.

Methods: This qualitative study was conducted in three tertiary hospitals in Riyadh, Saudi Arabia: two academic and one government military hospital. A total of 13 physicians from three hospitals participated in two focus groups. Discussions were audiotaped and transcribed verbatim. Transcripts were analysed using thematic content analysis and categorised into themes of error-producing conditions, latent conditions and both successful and unsuccessful defences, based on Reason’s Accident Causation Model.

Results: Error-producing conditions included the prescriber, the work environment, the team, the task, the patient and the computer system. The most commonly cited category related to the prescriber’s skills and knowledge. The most important latent conditions reported were a shortage of clinical pharmacists followed by lack of computerised physician order entry. The major unsuccessful defences were appropriate references and internet facilities, which were often unavailable.

Conclusion: Several causes of prescribing errors were identified. Lack of clinical pharmacists and lack of computerised prescribing systems are the key issues.

Keywords: Prescribing errors, Qualitative study, Computerized prescribing system, Reasonâ€™s accident causation model