This research carried out revealed some important issues that can help curb prescription errors in developing countries and for that matter Ghana. What I'm your opinion can best help solve this problem in our health sector?
prescription audits should be done in every hospital and necessary corrections should be done
pharmacovigilence is existing now in our institute which takes care mainly side effects and reactions of drugs. Same department takes care about proper prescription also.
simultaneously there is ANTIBIOTIC POLICY which will guide the proper use of antibiotics to prevent emerging drug resistance
Drug committee consists of Hospital administrator,pharmacist, pharmacologist, Microbiologist and in charge from each clinical department. Committee meets at regular intervals to discuss about the issues.
Implementation of this at every hospital can reduce improper prescriptions to large extent
Basic good practices by both physicians and pharmacists are the key to prescription errors.
In the paper you attached you noted that best practices are ignored by physicians who are in too much of a hurry. Pharmacists should refuse to fill improperly written prescriptions. That will force physicians to do their job better the first time.
There should also be control on the sale of drugs at counters with out any prescription. In developing countries antibiotics are available at medical shops and this leads to irrational use of antibiotics. This may be the reason for emerging drug resistance .
Drug resistance is the main problem we are facing now
reasons- wrong prescriptions
lack of compliance
Availability of drugs (antibiotics) at counters with out any prescription
Unless there is strict vigilance on above issues drug resistant organisms spread every where and it will be problem to treat the patient.
Agreed; drug resistance is a real problem. We will live to see a day when there are no effective antibiotics to treat infections if we don't get serious about the problem now.
How can prescription errors best be addressed in developing countries?
Electronic Health Record (EHR)
The Electronic health record (EHR), previously known as the Electronic medical record (EMR), reduces several types of errors, including those related to prescription drugs, to emergent and preventive care, and to tests and procedures.
Important features of modern EHR include automated drug-drug/drug-food interaction checks and allergy checks, standard drug dosages and patient education information. Drug Information at the point-of-care and drug dispensing points help in reducing errors.
Example: India, MedCLIK. Also, these systems provide recurring alerts to remind clinicians of intervals for preventive care and to track referrals and test results.
Clinical guidelines for disease management have a demonstrated benefit when accessible within the electronic record during the process of treating the patient.
Advances in health informatics and widespread adoption of interoperable electronic health records promise access to a patient's records at any health care site.
Still, there may be a weak link because of physicians' deficiencies in understanding the patient safety features of e.g. government approved software. Errors associated with patient misidentification may be exacerbated by EHR use, but inclusion of a prominently displayed patient photograph in the EHR can reduce errors and near misses.
Portable offline emergency medical record devices have been developed to provide access to health records during widespread or extended infrastructure failure, such as in natural disasters or regional conflicts.
EMR is unrealistic in many developing countries due to the costs involved.
You need a number of things: access to hardware to run the EMR. Access to proprietary software. IT to manage it. Infrastructure like consistent access to electricity.
I agree with Amy..EMR is not feasible option especially in developing countries. I would like to suggest a simpler options. Why not make a checklist of all the important components of a well written prescription like dose, frequency and duration etc. Just make a big chart and stick it in every OPD and pharmacy. So, physicians and pharmacists can have a ready reckoner to check the prescriptions. Also, it will act subconsciously and train the mind. You can use the major short comings from your research and include that in the chart. Why not try it in a few centres and see how it works. And it is cheaper than an EMR system!!
Dr. Upadhyay has hit the nail on the head. Standardized best practices is really the only way to go. Con ed offerings would help local physicians and nurses become familiar with these best practices. It would help if the local Ministries of Health or equivalent of the US Joint Commission would promote and support said practices.
One of the things that can help is influence from nurses by requesting physicians stick to standardized practices. For example, in the US nurses are expected by the Boards of Nursing in their states to question orders that are incomplete, unclear, poorly written or contain errors that could harm the patient.
Now I realized that in the developing world nurses don't have the statute we do in the developed world. But we managed decades ago on this issue when nursing had far less power and prestige, and when gender biases were more pronounced and even socially acceptable. I'm sure a determined effort on the part of nurses in these countries, in collaboration with physicians who care about the issue, would turn things around.