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Electronic prescribing reduces prescribing error in public hospitals

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  • Ramzi Shawahna,

    1. Authors:Ramzi Shawahna, MPhil, PhD Student, Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan, Faculté de Pharmacie, Université Paris Descartes, Paris, France and Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Nisar-Ur Rahman, PhD, Associate Professor and Chairman, Department of Pharmacy, The Islamia University of Bahawalpur; Mahmood Ahmad, PhD, Professor and Dean Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; Marcel Debray, Professor of Biostatistics, Université Paris-Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Département Santé Publique et Biostatistique, Paris, France; Marjo Yliperttula, PhD, Professor, Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Xavier Declèves, PhD, Associate Professor, Faculté de Pharmacie, Université Paris Descartes, Paris, France
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  • Nisar-Ur Rahman,

    1. Authors:Ramzi Shawahna, MPhil, PhD Student, Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan, Faculté de Pharmacie, Université Paris Descartes, Paris, France and Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Nisar-Ur Rahman, PhD, Associate Professor and Chairman, Department of Pharmacy, The Islamia University of Bahawalpur; Mahmood Ahmad, PhD, Professor and Dean Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; Marcel Debray, Professor of Biostatistics, Université Paris-Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Département Santé Publique et Biostatistique, Paris, France; Marjo Yliperttula, PhD, Professor, Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Xavier Declèves, PhD, Associate Professor, Faculté de Pharmacie, Université Paris Descartes, Paris, France
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  • Mahmood Ahmad,

    1. Authors:Ramzi Shawahna, MPhil, PhD Student, Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan, Faculté de Pharmacie, Université Paris Descartes, Paris, France and Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Nisar-Ur Rahman, PhD, Associate Professor and Chairman, Department of Pharmacy, The Islamia University of Bahawalpur; Mahmood Ahmad, PhD, Professor and Dean Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; Marcel Debray, Professor of Biostatistics, Université Paris-Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Département Santé Publique et Biostatistique, Paris, France; Marjo Yliperttula, PhD, Professor, Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Xavier Declèves, PhD, Associate Professor, Faculté de Pharmacie, Université Paris Descartes, Paris, France
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  • Marcel Debray,

    1. Authors:Ramzi Shawahna, MPhil, PhD Student, Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan, Faculté de Pharmacie, Université Paris Descartes, Paris, France and Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Nisar-Ur Rahman, PhD, Associate Professor and Chairman, Department of Pharmacy, The Islamia University of Bahawalpur; Mahmood Ahmad, PhD, Professor and Dean Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; Marcel Debray, Professor of Biostatistics, Université Paris-Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Département Santé Publique et Biostatistique, Paris, France; Marjo Yliperttula, PhD, Professor, Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Xavier Declèves, PhD, Associate Professor, Faculté de Pharmacie, Université Paris Descartes, Paris, France
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  • Marjo Yliperttula,

    1. Authors:Ramzi Shawahna, MPhil, PhD Student, Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan, Faculté de Pharmacie, Université Paris Descartes, Paris, France and Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Nisar-Ur Rahman, PhD, Associate Professor and Chairman, Department of Pharmacy, The Islamia University of Bahawalpur; Mahmood Ahmad, PhD, Professor and Dean Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; Marcel Debray, Professor of Biostatistics, Université Paris-Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Département Santé Publique et Biostatistique, Paris, France; Marjo Yliperttula, PhD, Professor, Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Xavier Declèves, PhD, Associate Professor, Faculté de Pharmacie, Université Paris Descartes, Paris, France
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  • Xavier Declèves

    1. Authors:Ramzi Shawahna, MPhil, PhD Student, Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan, Faculté de Pharmacie, Université Paris Descartes, Paris, France and Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Nisar-Ur Rahman, PhD, Associate Professor and Chairman, Department of Pharmacy, The Islamia University of Bahawalpur; Mahmood Ahmad, PhD, Professor and Dean Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; Marcel Debray, Professor of Biostatistics, Université Paris-Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Département Santé Publique et Biostatistique, Paris, France; Marjo Yliperttula, PhD, Professor, Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland; Xavier Declèves, PhD, Associate Professor, Faculté de Pharmacie, Université Paris Descartes, Paris, France
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Ramzi Shawahna, PhD Student, Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur-63100, Pakistan. Telephone: +92 62 9255243.
E-mail:ramzi_shawahna@hotmail.com

Abstract

Aims and objectives.  To examine the incidence of prescribing errors in a main public hospital in Pakistan and to assess the impact of introducing electronic prescribing system on the reduction of their incidence.

Background.  Medication errors are persistent in today’s healthcare system. The impact of electronic prescribing on reducing errors has not been tested in developing world.

Design.  Prospective review of medication and discharge medication charts before and after the introduction of an electronic inpatient record and prescribing system.

Methods.  Inpatient records (n = 3300) and 1100 discharge medication sheets were reviewed for prescribing errors before and after the installation of electronic prescribing system in 11 wards.

Results.  Medications (13,328 and 14,064) were prescribed for inpatients, among which 3008 and 1147 prescribing errors were identified, giving an overall error rate of 22·6% and 8·2% throughout paper-based and electronic prescribing, respectively. Medications (2480 and 2790) were prescribed for discharge patients, among which 418 and 123 errors were detected, giving an overall error rate of 16·9% and 4·4% during paper-based and electronic prescribing, respectively.

Conclusion.  Electronic prescribing has a significant effect on the reduction of prescribing errors.

Relevance to clinical practice.  Prescribing errors are commonplace in Pakistan public hospitals. The study evaluated the impact of introducing electronic inpatient records and electronic prescribing in the reduction of prescribing errors in a public hospital in Pakistan.

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