Medication errors: electronic vs. paper-based prescribing. Experience at a tertiary care university hospital

J Eval Clin Pract. 2016 Oct;22(5):751-4. doi: 10.1111/jep.12535. Epub 2016 May 1.

Abstract

Purpose: It has been estimated that medication errors (ME) are responsible for 7000 deaths each year. Some studies show that electronic prescribing systems have achieved health benefits and patient safety, resulting in a saving of resources. Other studies suggest that they may increase adverse events.

Objective: The objective of this study was to compare medication errors between electronic and paper-based prescription detected during pharmacovigilance.

Methods: This was an observational, cross-sectional comparative study of 600 randomized medical records that were systematically reviewed by a pharmacovigilance team, with a deliberate search for ME. Each error was classified according to its severity, National Coordinating Council for Medication Error and Prevention taxonomy and high-risk medications. The number of errors was calculated per 100 prescribed medications, number of errors per record and number of records with an error as a quality indicator.

Results: A total of 229 ME were found with a mean per record of 0.38 (SD = 0.7), of which 155 corresponded to the paper-based method (1.04, SD = 1.67) and 74 to the electronic-based method (0.29, SD = 0.57) P = <0.001. The use of the electronic method was associated with an OR of 0.59 (95% CI 0.41-0.85) for the recording of at least one ME (P = 0.005), but to a greater severity of ME (<0.001).

Conclusion: The use of the electronic system was associated with a reduction in ME, compared with the paper-based method. Despite this, it was associated with more severe ME.

Keywords: electronic prescribing; medication errors; paper-based prescribing.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Drug Prescriptions*
  • Electronic Prescribing*
  • Female
  • Hospitals, University*
  • Humans
  • Male
  • Medication Errors / prevention & control*
  • Middle Aged
  • Patient Safety
  • Pharmacovigilance
  • Tertiary Healthcare*