Displaying publications 1 - 20 of 53 in total

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  1. Ng YJ, Lo YL, Lee WS
    J Clin Pharm Ther, 2009 Feb;34(1):55-60.
    PMID: 19125903 DOI: 10.1111/j.1365-2710.2008.00985.x
    Acute gastroenteritis (AGE) is a common illness among infants and children contributing to significant mortality and morbidity. As such, appropriate treatment received prior to hospital admission is of utmost importance. This retrospective observational study aimed to determine preadmission management in paediatric patients prior to hospital admission. Two hundred and twenty-two case notes of paediatric AGE patients were reviewed over a 12-month period. One hundred and fifty-four patients received medications prior to admission with 143 (92.9%) patients received known classes of medications. Antipyretic agents were the most commonly prescribed (69.2%), followed by antibiotics (38.5%), anti-emetics (35.7%), oral rehydration salts (29.4%) and antidiarrhoeals (28.0%). The mean duration of stay in hospital was slightly shorter in patients, who received prior medications than those who did not (2.22 vs. 2.32 days respectively). Seventy per cent of children admitted for AGE were treated suboptimally prior to hospital admission with oral rehydration salts being largely under-utilized, despite their proven efficacy and safety. Sex, race and age had no influence on the type of preadmission treatment. A greater effort should be made to educate the general public in the appropriate treatment of AGE.
    Matched MeSH terms: Medication Errors
  2. Sellappans R, Lai PS, Ng CJ
    BMJ Open, 2015 Aug 27;5(8):e007817.
    PMID: 26316648 DOI: 10.1136/bmjopen-2015-007817
    OBJECTIVE: The aim of this study was to identify the challenges faced by primary care physicians (PCPs) when prescribing medications for patients with chronic diseases in a teaching hospital in Malaysia.
    DESIGN/SETTING: 3 focus group discussions were conducted between July and August 2012 in a teaching primary care clinic in Malaysia. A topic guide was used to facilitate the discussions which were audio-recorded, transcribed verbatim and analysed using a thematic approach.
    PARTICIPANTS: PCPs affiliated to the primary care clinic were purposively sampled to include a range of clinical experience. Sample size was determined by thematic saturation of the data.
    RESULTS: 14 family medicine trainees and 5 service medical officers participated in this study. PCPs faced difficulties in prescribing for patients with chronic diseases due to a lack of communication among different healthcare providers. Medication changes made by hospital specialists, for example, were often not communicated to the PCPs leading to drug duplications and interactions. The use of paper-based medical records and electronic prescribing created a dual record system for patients' medications and became a problem when the 2 records did not tally. Patients sometimes visited different doctors and pharmacies for their medications and this resulted in the lack of continuity of care. PCPs also faced difficulties in addressing patients' concerns, and dealing with patients' medication requests and adherence issues. Some PCPs lacked time and knowledge to advise patients about their medications and faced difficulties in managing side effects caused by the patients' complex medication regimen.
    CONCLUSIONS: PCPs faced prescribing challenges related to patients, their own practice and the local health system when prescribing for patients with chronic diseases. These challenges must be addressed in order to improve chronic disease management in primary care and, more importantly, patient safety.
    Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Medication Errors
  3. Shin JY, Shin E, Jeong HE, Kim JH, Lee EK
    Pharmacoepidemiol Drug Saf, 2019 03;28(3):362-369.
    PMID: 30648304 DOI: 10.1002/pds.4717
    PURPOSE: Regulatory discrepancies may exist in pharmacovigilance (PV) structure, process, and outcome status worldwide. Our study's objective was to survey the current status of PV in each regulatory body in the Asia-Pacific Economic Cooperation (APEC) region.

    METHODS: A modified questionnaire was sent to the PV team heads of 21 PV agencies based in the APEC countries, between June 28 and September 12, 2017, to gather information on the structure, process, and outcome of PV status in these countries.

    RESULTS: Of the 21 APEC countries, 15 responded. We found harmonized laws and regulations for general PV and risk management systems. However, variations were found in PV structure: for example, 11 out of 15 countries had national regulatory representatives responsible for PV in pharmaceutical companies, while four did not. For PV process, discrepancies were also found in the source type of adverse drug reaction (ADR) reports and reporting of medication errors and therapeutic ineffectiveness in cumulative ADR reports. With respect to PV outcomes, among countries that performed active surveillance, the United States of America was more active, with hundreds of projects including additional pharmacoepidemiological studies etc. Among the nine countries that responded, Japan had the greatest number of product label changes followed by Taiwan, Malaysia, and Korea.

    CONCLUSION: We have identified substantial variations in the structures, processes, and outcomes of PV status among the countries of the APEC region. Therefore, efforts to reduce variations in the PV administration and regulation are warranted for harmonization of PV within the APEC region.

    Matched MeSH terms: Medication Errors
  4. Samsuri SE, Lua PL, Fahrni ML
    BMJ Open, 2015 Nov 26;5(11):e008889.
    PMID: 26610761 DOI: 10.1136/bmjopen-2015-008889
    OBJECTIVE: To assess the safety attitudes of pharmacists, provide a profile of their domains of safety attitude and correlate their attitudes with self-reported rates of medication errors.
    DESIGN: A cross-sectional study utilising the Safety Attitudes Questionnaire (SAQ).
    SETTING: 3 public hospitals and 27 health clinics.
    PARTICIPANTS: 117 pharmacists.
    MAIN OUTCOME MEASURES: Safety culture mean scores, variation in scores across working units and between hospitals versus health clinics, predictors of safety culture, and medication errors and their correlation.
    RESULTS: Response rate was 83.6% (117 valid questionnaires returned). Stress recognition (73.0±20.4) and working condition (54.8±17.4) received the highest and lowest mean scores, respectively. Pharmacists exhibited positive attitudes towards: stress recognition (58.1%), job satisfaction (46.2%), teamwork climate (38.5%), safety climate (33.3%), perception of management (29.9%) and working condition (15.4%). With the exception of stress recognition, those who worked in health clinics scored higher than those in hospitals (p<0.05) and higher scores (overall score as well as score for each domain except for stress recognition) correlated negatively with reported number of medication errors. Conversely, those working in hospital (versus health clinic) were 8.9 times more likely (p<0.01) to report a medication error (OR 8.9, CI 3.08 to 25.7). As stress recognition increased, the number of medication errors reported increased (p=0.023). Years of work experience (p=0.017) influenced the number of medication errors reported. For every additional year of work experience, pharmacists were 0.87 times less likely to report a medication error (OR 0.87, CI 0.78 to 0.98).
    CONCLUSIONS: A minority (20.5%) of the pharmacists working in hospitals and health clinics was in agreement with the overall SAQ questions and scales. Pharmacists in outpatient and ambulatory units and those in health clinics had better perceptions of safety culture. As perceptions improved, the number of medication errors reported decreased. Group-specific interventions that target specific domains are necessary to improve the safety culture.
    Study site: Klinik kesihatan, hospitals, Malaysia
    Matched MeSH terms: Medication Errors/statistics & numerical data
  5. Dhabali AA, Awang R, Zyoud SH
    Int J Clin Pharmacol Ther, 2011 Aug;49(8):500-9.
    PMID: 21781650 DOI: 10.5414/cp201524
    BACKGROUND: The prescription of contraindicated drugs is a preventable medication error, which can cause morbidity and mortality. Recent data on the factors associated with drug contraindications (DCIs) is limited world-wide, especially in Malaysia.

    AIMS: The objectives of this study are 1) to quantify the prevalence of DCIs in a primary care setting at a Malaysian University; 2) to identify patient characteristics associated with increased DCI episodes, and 3) to identify associated factors for these DCIs.

    METHODS: We retrospectively collected data from 1 academic year using computerized databases at the Universiti Sains Malaysia (USM) from patients of USM's primary care. Descriptive and comparative statistics were used to characterize DCIs.

    RESULTS: There were 1,317 DCIs during the study period. These were observed in a cohort of 923 patients, out of a total of 17,288 patients, representing 5,339 DCIs per 100,000 patients, or 5.3% of all patients over a 1-year period. Of the 923 exposed patients, 745 (80.7%) were exposed to 1 DCI event, 92 (10%) to 2 DCI events, 35 (3.8%) to 3 DCI events, 18 (2%) to 4 DCI events, and 33 patients (3.6%) were exposed to 5 or more DCI events. The average age of the exposed patients was 30.7 ± 15 y, and 51.5% were male. Multivariate logistic regression analysis revealed that being male (OR = 1.3; 95% CI = 1.1 - 1.5; p < 0.001), being a member of the staff (OR = 3; 95% CI = 2.5 - 3.7; p < 0.001), having 4 or more prescribers (OR = 2.8; 95% CI = 2.2 - 3.6; p < 0.001), and having 4 or more longterm therapeutic groups (OR = 2.3; 95%CI = 1.7 - 3.1; p < 0.001), were significantly associated with increased chance of exposure to DCIs.

    DISCUSSION AND CONCLUSIONS: This is the first study in Malaysia that presents data on the prevalence of DCIs. The prescription of contraindicated drugs was found to be frequent in this primary care setting. Exposure to DCI events was associated with specific socio-demographic and health status factors. Further research is needed to evaluate the relationship between health outcomes and the exposure to DCIs.
    Matched MeSH terms: Medication Errors/statistics & numerical data*
  6. Hon MY, Chua XY, Premakumar CM, Mohamed Shah N
    Int J Clin Pharm, 2020 Jun;42(3):948-955.
    PMID: 32356248 DOI: 10.1007/s11096-020-01045-w
    Background Drug-related problems are relatively common among hospitalised patients and may be detrimental to patients and even increase healthcare costs. Characterising drug-related problems allows remedial actions to be in place to minimise the frequency and ensure higher medication safety for the patients involved. Currently, the incidence of drug-related problems among hospitalised paediatric patients in Malaysia is unknown. Objective To determine the incidence, types and intervention acceptance, as well as the risk factors associated with drug-related problems in a Malaysian general paediatric ward. Setting General paediatric ward in Universiti Kebangsaan Malaysia Medical Centre. Method A cross-sectional observational study was conducted from March to May 2019. Data were collected from patients' medical charts, clinical notes and medical records for problem identification based on the modified Pharmaceutical Care Network Europe (PCNE) classification V 8.02. The incidence, types, causes and intervention acceptance as well as the risk factors were assessed. Main outcome measure Drug-related problems based on the modified PCNE classification V 8.02. Results In total, 225 paediatric patients with a total of 694 prescriptions were included in this study. The incidence of drug-related problems was 52.9% (198 prescriptions with problems in 119 patients). The main types of problems were treatment safety (68 prescriptions, 34.3%), incomplete prescription (56 prescriptions, 28.3%) and un-optimised drug treatment (35 prescriptions, 17.7%). The main causes for the problems were necessary information not provided (n = 63, 30.1%), inappropriate dose selection (n = 47, 22.5%) and medication served without a valid prescription (n = 40, 19.1%). Of the 143 interventions proposed to prescribers by the pharmacist, 117 (81.8%) were accepted. The number of prescriptions was found to be the only risk factor associated with DRPs (odds ratio, 1.91; 95% confidence interval, 1.54-2.38; p 
    Matched MeSH terms: Medication Errors/statistics & numerical data*
  7. Fatokun O
    Curr Drug Saf, 2020;15(3):181-189.
    PMID: 32538733 DOI: 10.2174/1573403X16666200615144946
    BACKGROUND: While off-label drug use is common and sometimes necessary, it also presents considerable risks. Therefore, measures intended to prevent or reduce the potential exposure to off-label risks have been recommended. However, little is known about community pharmacists' beliefs regarding these measures in Malaysia.

    OBJECTIVES: This study examined community pharmacists' beliefs towards risk minimization measures in off-label drug use in Malaysia and assessed the relationship between perceived risk of off-label drug use and beliefs towards risk minimization measures.

    METHODS: A cross-sectional survey was conducted among 154 pharmacists practicing in randomly selected community pharmacies in Kuala Lumpur and the State of Selangor, Malaysia.

    RESULTS: The majority agreed or strongly agreed that adverse drug events from the off-label drug should be reported to the regulatory authority (90.9%) and the off-label drug should only be used when the benefit outweighs potential risks (88.3%). Less than half (48.1%) agreed or strongly agreed that written informed consent should be obtained before dispensing off-label drugs and a majority (63.7%) agreed or strongly agreed that the informed consent process will be burdensome to healthcare professionals. Beliefs towards risk minimization measures were significantly associated with perceived risk of off-label drug use regarding efficacy (p = 0. 033), safety (p = 0.001), adverse drug rection (p = 0.001) and medication errors (p = 0.002).

    CONCLUSION: The community pharmacists have positive beliefs towards most of the risk minimization measures. However, beliefs towards written informed consent requirements are not encouraging. Enhancing risk perception may help influence positive beliefs towards risk minimization measures.

    Matched MeSH terms: Medication Errors/prevention & control
  8. Neoh CF, Hassali MA, Shafie AA, Awaisu A, Tambyappa J
    Curr Drug Saf, 2009 Sep;4(3):199-203.
    PMID: 19534650
    Good medicine labelling practice is vital to ensure safe use of medicines. Non-compliance to labelling standards is a potential source of medication errors. This study was intended to evaluate and compare compliance towards labelling standard for dispensed medications between community pharmacists and general practitioners in Penang, Malaysia. A total of 128 community pharmacies and 26 general practitioners' clinics were visited. Using 'Simulated Client Method' (SCM), data were collected on the medications dispensed upon presentation of hypothetical common cold symptoms. The medications dispensed were evaluated for labelling adequacy. Result revealed that majority of the dispensed medications obtained were not labelled according to regulatory requirements. However, general practitioners complied better than community pharmacists in terms of labelling for: name of patient (p<0.001), details of supplier (p<0.001), dosage of medication (p=0.023), frequency to take medication (p=0.023), patient's reference number (p<0.001), date of supply (p<0.001), special instructions for medication (p=0.008), storage requirements (p=0.002), and indication for medication (p<0.001). Conversely, community pharmacists labelled dispensed medications with the words "Controlled Medicine" more often than did general practitioners (p<0.001). Although laws for labelling dispensed medicines are in place, most community pharmacists and general practitioners did not comply accordingly, thereby putting patients' safety at risks of medication errors.
    Matched MeSH terms: Medication Errors/prevention & control
  9. Haseeb A, Winit-Watjana W, Bakhsh AR, Elrggal ME, Hadi MA, Mously AA, et al.
    BMJ Open, 2016 06 16;6(6):e011401.
    PMID: 27311911 DOI: 10.1136/bmjopen-2016-011401
    OBJECTIVES: To evaluate the effectiveness of a pharmacist-led educational intervention to reduce the use of high-risk abbreviations (HRAs) by healthcare professionals.

    DESIGN: Quasi-experimental study consisting of a single group before-and-after study design.

    SETTING: A public emergency hospital in Mecca, Saudi Arabia.

    PARTICIPANTS: 660 (preintervention) and then 498 (postintervention) handwritten physician orders, medication administration records (MRAs) and pharmacy dispensing sheets of 482 and 388 patients, respectively, from emergency wards, inpatient settings and the pharmacy department were reviewed.

    INTERVENTION: The intervention consisted of a series of interactive lectures delivered by an experienced clinical pharmacist to all hospital staff members and dissemination of educational tools (flash cards, printed list of HRAs, awareness posters) designed in line with the recommendations of the Institute for Safe Medical Practices and the US Food and Drug Administration. The duration of intervention was from April to May 2011.

    MAIN OUTCOME: Reduction in the incidence of HRAs use from the preintervention to postintervention study period.

    FINDINGS: The five most common abbreviations recorded prior to the interventions were 'IJ for injection' (28.6%), 'SC for subcutaneous' (17.4%), drug name and dose running together (9.7%), 'OD for once daily' (5.8%) and 'D/C for discharge' (4.3%). The incidence of the use of HRAs was highest in discharge prescriptions and dispensing records (72.7%) followed by prescriptions from in-patient wards (47.3%). After the intervention, the overall incidence of HRA was significantly reduced by 52% (ie, 53.6% vs 25.5%; p=0.001). In addition, there was a statistically significant reduction in the incidence of HRAs across all three settings: the pharmacy department (72.7% vs 39.3%), inpatient settings (47.3% vs 23.3%) and emergency wards (40.9% vs 10.7%).

    CONCLUSIONS: Pharmacist-led educational interventions can significantly reduce the use of HRAs by healthcare providers. Future research should investigate the long-term effectiveness of such educational interventions through a randomised controlled trial.

    Matched MeSH terms: Medication Errors/prevention & control*
  10. Huckvale C, Car J, Akiyama M, Jaafar S, Khoja T, Bin Khalid A, et al.
    Qual Saf Health Care, 2010 Aug;19 Suppl 2:i25-33.
    PMID: 20693213 DOI: 10.1136/qshc.2009.038497
    BACKGROUND: Research on patient care has identified substantial variations in the quality and safety of healthcare and the considerable risks of iatrogenic harm as significant issues. These failings contribute to the high rates of potentially avoidable morbidity and mortality and to the rising levels of healthcare expenditure seen in many health systems. There have been substantial developments in information technology in recent decades and there is now real potential to apply these technological developments to improve the provision of healthcare universally. Of particular international interest is the use of eHealth applications. There is, however, a large gap between the theoretical and empirically demonstrated benefits of eHealth applications. While these applications typically have the technical capability to help professionals in the delivery of healthcare, inadequate attention to the socio-technical dimensions of their use can result in new avoidable risks to patients.

    RESULTS AND DISCUSSION: Given the current lack of evidence on quality and safety improvements and on the cost-benefits associated with the introduction of eHealth applications, there should be a focus on implementing more mature technologies; it is also important that eHealth applications should be evaluated against a comprehensive and rigorous set of measures, ideally at all stages of their application life cycle.

    Matched MeSH terms: Medication Errors/prevention & control
  11. Rajah R, Hanif AA, Tan SSA, Lim PP, Karim SA, Othman E, et al.
    Int J Clin Pharm, 2019 Feb;41(1):237-243.
    PMID: 30506127 DOI: 10.1007/s11096-018-0762-1
    Background Detecting errors before medication dispensed or 'near misses' is a crucial step to combat the incidence of dispensing error. Despite this, no published evidence available in Malaysia relating to these issues. Objective To determine the incidence of medication labeling and filling errors, frequency of each type of the errors and frequency of the contributing factors at the final stage before dispensing. Setting Six Penang public funded hospitals outpatient pharmacies. Methods A prospective multicentre study, over 8 week's period. Pharmacists identified and recorded the details of either medication labeling and/or filling error at the final stage of counter-checking before dispensing. Besides, the contributing factors for each error were determined and recorded in data collection form. Descriptive analysis was used to explain the study data. Main outcome measure The incidence of near misses. Results A total of 187 errors (near misses) detected, with 59.4% (n = 111) were medication filling errors and 40.6% (n = 76) were labeling errors. Wrong drug (n = 44, 39.6%) was identified as the highest type of filling errors while incorrect dose (n = 34, 44.7%) was identified as the highest type of labeling errors. Distracted and interrupted work environment was reported to lead the highest labeling and filling errors, followed by lack of knowledge and skills for filling errors and high workload for labeling errors. Conclusion The occurrence of near misses related to medication filling and labelling errors is substantial at outpatient pharmacy in Penang public funded hospitals. Further research is warranted to evaluate the intervention strategies needed to reduce the near misses.
    Matched MeSH terms: Medication Errors/prevention & control*
  12. Samsiah A, Othman N, Jamshed S, Hassali MA
    Int J Clin Pharm, 2020 Aug;42(4):1118-1127.
    PMID: 32494990 DOI: 10.1007/s11096-020-01041-0
    Background Medication errors are the most common types of medical errors that occur in health care organisations; however, these errors are largely underreported. Objective This study assessed knowledge on medication error reporting, perceived barriers to reporting medication errors, motivations for reporting medication errors and medication error reporting practices among various health care practitioners working at primary care clinics. Setting This study was conducted in 27 primary care clinics in Malaysia. Methods A self-administered survey was distributed to family medicine specialists, doctors, pharmacists, pharmacist assistants, nurses and assistant medical officers. Main outcome measures Health care practitioners' knowledge, perceived barriers and motivations for reporting medication errors. Results Of all respondents (N = 376), nurses represented 31.9% (n = 120), followed by doctors (n = 87, 23.1%), pharmacists (n = 63, 16.8%), assistant medical officers (n = 53, 14.1%), pharmacist assistants (n = 46, 12.2%) and family medicine specialists (n = 7, 1.9%). Of the survey respondents who had experience reporting medication errors, 56% (n = 62) had submitted medication error reports in the preceding 12 months. Results showed that 41.2% (n = 155) of respondents were classified as having good knowledge on medication error and medication error reporting. The mean score of knowledge was significantly higher among prescribers and pharmacists than nurses, pharmacist assistants and assistant medical officers (p 
    Matched MeSH terms: Medication Errors*
  13. Lee JL
    Int J Clin Pharm, 2020 Apr;42(2):604-609.
    PMID: 32095976 DOI: 10.1007/s11096-020-00996-4
    Background Prescribing errors in children are common due to individualization of dosage regimen. It potentially has a great impact especially in this vulnerable population. Objective To determine the prevalence and common types of prescribing errors in a Malaysian pediatric outpatient department and to determine the factors contributing to prescribing errors. Setting Pediatric Outpatient Department and Outpatient Pharmacy at a tertiary care hospital in Malaysia. Method This is a prospective, cross sectional observational study where all new prescriptions received by the outpatient pharmacy from patients attending pediatric out-patient clinic were included for analysis. Descriptive statistics and logistic regression were used to analyze the data. Main outcome measure Frequency, types, potential clinical consequences and contributing factors of prescribing errors. Results Two hundred and fifty new prescriptions with 493 items were analyzed. There were 13 per 100 prescriptions with at least one prescribing error and 7.3% of the total items were prescribed incorrectly. The most common types of prescribing error were, an ambiguous prescription (61.1%) followed by an unrecommended dose regimen (13.9%). Logistic regression analysis showed that the risk of a prescribing error significantly increased when the prescription was written by a house officer (OR 4.72, p = 0.029). Errors were judged to be potentially non-significant (33.3%), significant (36.1%), or serious (30.6%). Conclusion The experience of prescribers is an important factor that contributes to prescribing errors in pediatrics. Many of the errors made were potentially serious and may impact on the patients' well-being.
    Matched MeSH terms: Medication Errors/prevention & control*
  14. Wan Mat WR, Yahya N, Izaham A, Abdul Rahman R, Abdul Manap N, Md Zain J
    Int J Risk Saf Med, 2014;26(2):57-60.
    PMID: 24902502 DOI: 10.3233/JRS-140611
    Acute pain service (APS) ensures provision of effective and safe postoperative pain relief. The following cases describe a potentially fatal error in managing patients who receive epidural analgesia postoperatively.
    Matched MeSH terms: Medication Errors/adverse effects*
  15. Chua SS, Lai PSM, Sim SM, Tan CH, Foong CC
    BMC Med Educ, 2019 Apr 05;19(1):101.
    PMID: 30953493 DOI: 10.1186/s12909-019-1525-y
    BACKGROUND: The success of interprofessional collaboration in healthcare services requires a paradigm shift in the training of future health profession practitioners. This study aimed to develop and validate an instrument to measure Student Acceptance of Interprofessional Learning (SAIL) in Malaysia, and to assess this attribute among medical and pharmacy students using a prescribing skills training workshop.

    METHODS: The study consisted of two phases. In Phase 1, a 10-item instrument (SAIL-10) was developed and tested on a cohort of medical and pharmacy students who attended the workshop. In Phase 2, different cohorts of medical and pharmacy students completed SAIL-10 before and after participating in the workshop.

    RESULTS: Factor analysis showed that SAIL-10 has two domains: "facilitators of interprofessional learning" and "acceptance to learning in groups". The overall SAIL-10 and the two domains have adequate internal consistency and stable reliability. The total score and scores for the two domains were significantly higher after students attended the prescribing skills workshop.

    CONCLUSIONS: This study produced a valid and reliable instrument, SAIL-10 which was used to demonstrate that the prescribing skills workshop, where medical and pharmacy students were placed in an authentic context, was a promising activity to promote interprofessional learning among future healthcare professionals.

    Matched MeSH terms: Medication Errors/prevention & control*
  16. Khoo EM, Lee WK, Sararaks S, Abdul Samad A, Liew SM, Cheong AT, et al.
    BMC Fam Pract, 2012 Dec 26;13:127.
    PMID: 23267547 DOI: 10.1186/1471-2296-13-127
    BACKGROUND: Patient safety is vital in patient care. There is a lack of studies on medical errors in primary care settings. The aim of the study is to determine the extent of diagnostic inaccuracies and management errors in public funded primary care clinics.

    METHODS: This was a cross-sectional study conducted in twelve public funded primary care clinics in Malaysia. A total of 1753 medical records were randomly selected in 12 primary care clinics in 2007 and were reviewed by trained family physicians for diagnostic, management and documentation errors, potential errors causing serious harm and likelihood of preventability of such errors.

    RESULTS: The majority of patient encounters (81%) were with medical assistants. Diagnostic errors were present in 3.6% (95% CI: 2.2, 5.0) of medical records and management errors in 53.2% (95% CI: 46.3, 60.2). For management errors, medication errors were present in 41.1% (95% CI: 35.8, 46.4) of records, investigation errors in 21.7% (95% CI: 16.5, 26.8) and decision making errors in 14.5% (95% CI: 10.8, 18.2). A total of 39.9% (95% CI: 33.1, 46.7) of these errors had the potential to cause serious harm. Problems of documentation including illegible handwriting were found in 98.0% (95% CI: 97.0, 99.1) of records. Nearly all errors (93.5%) detected were considered preventable.

    CONCLUSIONS: The occurrence of medical errors was high in primary care clinics particularly with documentation and medication errors. Nearly all were preventable. Remedial intervention addressing completeness of documentation and prescriptions are likely to yield reduction of errors.

    Matched MeSH terms: Medication Errors/statistics & numerical data*
  17. Oh AL, Tan AGHK, Chieng IYY
    J Pharm Pract, 2021 Jan 12.
    PMID: 33433248 DOI: 10.1177/0897190020987127
    INTRODUCTION: Medication history assessment during hospital admissions is an important element in the medication reconciliation process. It ensures continuity of care and reduces medication errors.

    OBJECTIVES: This study aimed to determine the incidence of unintentional discrepancies (medication errors), types of medication errors with its potential severity of patient harm and acceptance rate of pharmaceutical care interventions.

    METHODS: A four-month cross-sectional study was conducted in the general medical wards of a tertiary hospital. All newly admitted patients with at least one prescription medication were recruited via purposive sampling. Medication history assessments were done by clinical pharmacists within 24 hours or as soon as possible after admission. Pharmacist-acquired medication histories were then compared with in-patient medication charts to detect discrepancies. Verification of the discrepancies, interventions, and assessment of the potential severity of patient harm resulting from medication errors were collaboratively carried out with the treating doctors.

    RESULTS: There were 990 medication discrepancies detected among 390 patients recruited in this study. One hundred and thirty-five (13.6%) medication errors were detected in 93 (23.8%) patients (1.45 errors per patient). These were mostly contributed by medication omissions (79.3%), followed by dosing errors (9.6%). Among these errors, 88.2% were considered "significant" or "serious" but none were "life-threatening." Most (83%) of the pharmaceutical interventions were accepted by the doctors.

    CONCLUSION: Medication history assessment by pharmacists proved vital in detecting medication errors, mostly medication omissions. Majority of the errors intervened by pharmacists were accepted by the doctors which prevented potential significant or serious patient harm.

    Matched MeSH terms: Medication Errors
  18. Li Tsu Chong, Josephine Magdeline Joseph, Nur Atikah Binti Mohd Taib, Nurfirna Suzleyna Binti Mohd Salleh, Jennefer Henry
    MyJurnal
    Introduction: Medication error always happens among the nurses either the trained out staffs nor in nursing students. These errors may harm any patient that is involved and it may lead tolegislation issue. Therefore, this study aims to identify nursing students knowledge and assurance in medication administration. Methods: This study using a cross-sectional survey design using a convenience sampling method. Ethical approval was obtained from The Fac- ulty of Medicine and Health Sciences Ethical Committee. Adapted questionnaire divided into three sections with 14 multi-choice questions for each section (pharmacology, drug management and drug calculation) score (0-14) and Self perceived certainty on their correct answer were scored (1-high certainty, 2-moderate and 3-low certainty). Questionnaires were distributed through the online google form to Diploma of Nursing students of year two and three of Faculty Medicine and Health Science of University Malaysia Sabah. Result reported in mean (+SD). Results: Total of71 students volunteered responded to the survey. 42.3% of respondents (n=30) are the Year Two students and 57.7% (n=41) are the Year Three students.In knowledge about pharmacology mean score was 9.33 (2.37) and their certainty mean score was 1.9 (0.55), Drug management mean score was 8.42 (2.55) and their certainty mean score was 1.90 (0.45), While for their drug calculation mean score was 8.04 (3.03) and certainty mean score was
    2.13 (0.51). Conclusion: Knowledge in drug management and drug calculation both were below the appropriate score (less than 9) respectively. These indicate that more practices and training on the medication administration should be done to the students in order familiar with the context of medication administration. Their certainty level found moderate indicate that their confidence level on medication administration should be reinforced. Nursing educators need to facilitate the students in their learning process and training periods to gain their confidence before their graduation.

    Matched MeSH terms: Medication Errors
  19. Chan HK, Hassali MA, Lim CJ, Saleem F, Ghani NA
    Pharm Pract (Granada), 2016 Apr-Jun;14(2):699.
    PMID: 27382422 DOI: 10.18549/PharmPract.2016.02.699
    BACKGROUND: Inadequacies of drug labeling have been frequently reported among Malaysian healthcare institutes, in which the Hospital Information System (HIS) is used.
    OBJECTIVE: To identify potential areas to improve the existing labels used for pediatric liquid medications.
    METHODS: This study was qualitative in nature, whereby focus group discussions (FGDs), face-to-face interviews (FTFIs), and onsite observation were used for data collection. Pharmacists stationed at three units (outpatient, inpatient and clinical pharmacy) of a tertiary hospital were targeted. Both FGDs and FTFIs were facilitated using a semi-structured interview guide, video-recorded and transcribed verbatim. All transcripts were thematically analyzed using content analysis approach.
    RESULTS: Thirteen pharmacists participated in FGDs, while five were approached for FTFIs. Data analysis resulted in four major themes: format of labels, presentation of medication instructions, insufficiency of information, and the need for external aids and education. Participants unanimously agreed on the need for enlarging font sizes of key information. Suggestions were made to use more specific instructions for administration times and pictograms to illustrate important directions. The absence of information about storage, stability and handling of liquid medications was also highlighted. While discussion mainly focused on improving drug labeling, participants consistently stressed the need for an instruction sheet and pharmacist-based, one-to-one education regarding medication instructions.
    CONCLUSION: This study provides important insights into critical shortcomings in current labeling practice, underlying the need for developing a new label that incorporates a new format, additional information and pictograms for pediatric liquid medications.
    KEYWORDS: Child; Drug labeling; Hospital; Hospital Information Systems; Malaysia; Medication Errors; Pharmacy Service
    Matched MeSH terms: Medication Errors
  20. Shitu, Zayyanu, Isyaku Hassan, Aung, Myat Moe Thwe, Musa, Rabiu Muazu, Tuan Hairulnizam Tuan Kamaruzaman
    Movement Health & Exercise, 2018;7(1):115-128.
    MyJurnal
    One of the major problems causing medication errors is ineffective
    communication between patients and health personnel. This paper discusses
    the communication issues in the healthcare environment and how
    medication errors can be avoided through effective communication. An
    internet-based search was conducted to locate relevant articles published
    between 2004 and 2017. Only articles that touch upon communication and
    health-related issues were selected. Online sources such as PubMed,
    ScienceDirect, and Google Scholar were utilized. The importance of good
    communication practices for effective health and improved patient safety in
    hospital settings has been highlighted. It is evident from this review that
    poor communication most frequent causes adverse effects, delay in
    treatment, medication errors, and wrong-site surgery. The major
    communication issues in healthcare environment include language barriers,
    the medium of communication, physical setting, and social setting.
    Healthcare workers tend to use technical language in the workplace because
    they consider the tone of communication to be always professional. It has
    been established that knowledge on professional-patient communication is
    essential and valuable in improving therapeutic outcomes. Patients need
    knowledge and support in order to be able and motivated to undergo
    medicine therapy. Health practitioners need to take responsibility for
    demanding and creating an environment where high-quality healthcare
    counselling is routinely practiced. To promote safe and effective practice in hospitals and avoid medication errors, clinicians should adhere to teamwork
    and effective communication with the patients. There is a need for designing
    strategies such as effective communication and teamwork amongst
    healthcare professionals, which can consequently influence the quality of
    healthcare services and patient outcomes.
    Matched MeSH terms: Medication Errors
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