The Associated Factors for Prescribing Errors and Drug Related Problems in Stroke Outpatients, the Secondary Care Chiang Kham Hospital Phayao Province
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Abstract
Prescribing errors and drug related problems are important causes affecting drug safety in stroke patients who are typically old with complications, comorbidities and long-term drug therapy. This study aims to explore contributing factors for prescribing errors and drug related problems in outpatients with stroke at Chiang Kham Hospital, the secondary care hospital with 231 beds in Phayao Province. Methods: This analytical cross-sectional study used 3,079 stroke outpatient prescriptions that were retrospectively retrieved between 2019 October 1 and 2020 September 30, together with hospital occurrence incident data. The analysis used Multilevel, mixed model, and logistic regression to perform the exploratory model with significant level at 0.05. Results: Majority patients are older than 60 years old (83.3%) and remain in universal health coverage up to 91.7%. Three significant factors for prescribing errors and drug related problems were revealed. Comprising (1) ischemic heart diseases, pulmonary heart disease and disease of pulmonary circulation and other forms of heart diseases (I20-28, I30-52) (OR=7.2, 95% CI=2.1-24.4, P<0.001), (2) congenital malformations, deformations and chromosomal abnormalities (Q00-99) (OR=18.0, 95% CI=1.4-223.4, P=0.02) and (3) diseases of the digestive system (K00-93) (OR=6.8, 95% CI=1.3-36.2, P=0.02), after nested within individual hospital patient numbers because one patient may take multiple prescriptions (1,057 patients with 3,079 prescriptions) and adjusted for sex, patient age-group, medical benefit scheme, working time and prescriber group. Conclusion: Heart disease, congenital abnormalities, and diseases of the digestive system were all associated with prescribing errors and drug related problems. Those who use medication with concern. The analysis of annual medication use data and hospital incident reporting for safety prescribing monitoring strategy should be considered for hospital risk management.
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