Evaluation of Inpatients Medication Prescribing Practice at Ibrahim Malik Teaching Hospital: A Descriptive Cross-sectional Study

Abstract

Introduction: Prescribing errors account for almost 50% of medication errors and represent the eighth leading cause of death in the US. The current study aimed to evaluate inpatient prescribing practice by assessing adherence to prescription-writing guidelines and identifying the frequency and severity of drug-drug interactions (DDIs) and drug-disease interactions (DDSIs). Methods: An observational-descriptive cross-sectional study was conducted among inpatient wards in Ibrahim Malik teaching hospital, Khartoum, Sudan. Total coverage sampling was performed and the sample size consisted of 132 prescriptions containing a total of 700 prescribed drugs. The data were collected from patients’ files, and the completeness of prescriptions was assessed according to national and international guidelines. Drug interactions were checked by the interaction checker of www.drug.com. Results: The overall prescription completeness was 0%, and the completeness of both prescriber data and medication data were 1.5%, (0.4% for Intravenous [IV] and 0.6% for non-IV drugs), respectively. The most missing elements of the prescription were duration and qualification. Moreover, only 25% of the prescribed drugs were written in the Prescription and Medication Administration Record or drug chart, but the rest were written elsewhere within the patient’s file. The prescriptions containing DDIs and DDSIs were 49.2% and 46.2%, respectively, ranging from major (9.1%), moderate, (40.9%), and minor (28%) for DDIs, major (30.3%), moderate (33.3%), and minor (0.8%) for DDSIs. The highest percentage of drug interactions was found in the internal medicine ward. Diabetes was significantly associated with both DDIs (P = 0.003) and DDSIs (P = 0.031). Conclusion: The findings of this study reflect a real problem in prescribing practice, as no prescription was considered to be complete, and nearly half of the patients were exposed to DDIs and/or DDSIs.