Factors Associated with Prescribing Errors in Outpatients with Chronic Kidney Disease in Chiangkham Hospital, Phayao Province

Abstract

Objective: To explore the factors contributing to prescribing errors in outpatients with chronic kidney disease (CKD) at Chiangkham Hospital, Phayao Province. Method: This analytical cross-sectional research retrospectively collected data from 32,260 prescriptions of chronic kidney disease patients from electronic medical records from October 1, 2019 to September 30, 2020 and from the report on risk incidence within the hospital during the same period. Th relationship between prescribing errors and various factors was analyzed using multilevel, mixed model, logistic regression. The analysis was conducted when considering prescription data at the level of each patient's hospital number (because one patient may have multiple prescriptions, 5,838 patients with 32,260 prescriptions) and the effects of gender, age group, health benefit scheme, and working days were adjusted. Results: Factors affecting prescribing errors were duty shift at late night hours from 24.00 to 8.00 (OR=27.66, 95% CI=1.50-511.46, P<0.03), the first year internist prescribers (OR=7.62, 95% CI=4.07-14.27, P<0.001) and some comorbidities including pulmonary heart disease and pulmonary circulation disorder and other heart diseases (I26-28, I30-52) (OR=3.65, 95% CI=2.09-6.37, P<0.001). Conclusion: Factors associated with the occurrence of prescribing errors in patients with chronic kidney disease included working hours, group of prescribers and patients with complicated comorbidities or taking high-risk drugs. The results of this study can be used as information for hospital risk management. In addition, regular surveillance should be taken to prevent prescribing errors in outpatients with chronic kidney disease.