A Retrospective Study of Prescribing Error Associated with The Computerized Prescribing System and The Handwritten Prescribing System Among Prescriptions in a Private Hospital, Chiang Mai Province

Abstract

OBJECTIVES: To compare prescribing errors arising from prescribing drugs by computerized prescribing system and handwritten prescribing system and to explore the possible factors that cause prescribing errors between the two systems. MATERIALS AND METHODS: : A retrospective study collected data from outpatient prescriptions at Bangkok Hospital Chiang Mai from January 1- December 31, 2019 by a simple random sampling method. A total of 18,211 drug prescriptions were included in this study which consisted of prescribing the drug with the computerized prescribing system and the handwritten prescribing system. The data obtained were analyzed by frequency distribution, percentage, mean and standard deviation. Factors that caused discrepancies in prescribing drugs during computerized prescribing and handwritten prescriptions were tested by means of Chi-square test. A value of 0.05 odds ratio and 95% Confident interval was considered statistically significant. RESULTS: In this study, the discrepancy from the handwritten prescribing system was 2.6 % higher than that of the computerized prescribing system (0.24%). The study was also classified by the severity of the discrepancy which demonstrate both systems experienced the highest severity on a scale of 0 (Near miss event) by 2.6 % for the handwritten prescribing system and 0.2 % for the computerized prescribing system. In addition, the top three discrepancy errors from computerized prescribing were wrong time, wrong dose and wrong quantity at 0.07%, 0.06% and 0.05 %, respectively. As for the handwritten prescribing system, the discrepancy errors were wrong time, wrong quantity and wrong dose at 1.24%, 0.56% and 0.35%, respectively. CONCLUSION: There were significant differences in the proportion of errors in the group of the handwritten prescribing system and the computerized prescribing systems (OR = 0.091, p < 0.05); namely, the risk of errors by the computerized prescribing systems was reduced by 91% compared with the handwritten prescribing system. However, there were no statistically significant differences in physician ‘s work experience, departments, and age groups.