Investigation of Medication Errors: A Prescription Survey from Sri Lanka

Purpose: To identify and quantify possible errors in handwritten outpatient prescriptions in relation to adherence to standard guidelines on the layout and content of prescriptions.
Method: A sample of 200 handwritten outpatient prescriptions were collected from two pharmacies located in a sub-urban (Aluthgama) and an urban (Kandy) area in Sri Lanka. Data were extracted using a pilot-tested questionnaire and the legibility of the prescription was assessed by three independent investigators. The results from the suburban area were compared with those from the urban area.
Results: Based on the layout of the prescription, the presence of patient information was unsatisfactory. Patient name and age were present in less than half of the prescriptions. However, prescriber information except registration number was present in more than 75 % of the prescriptions. Date of consultation was present in > 81.5 % of the prescriptions. Non-standard abbreviations were used in 36.5 % of the prescriptions while incomplete units were observed in 51 % of the prescriptions. Nearly half of the prescriptions from both urban and suburban locations were illegible. Occurrence of prescriber details was a significantly different between Aluthgama and Kandy.
Conclusion: Prescription errors are common in outpatient settings of Aluthgama and Kandy areas in Sri Lanka. Standardized prescription writing process in relation to layout, use of abbreviations, and units and legibility, is proposed as a potential solution to overcome this problem.

Keywords
Medication error; Prescriptions; Standardized prescription writing; Prescriber information; Non-standard abbreviation