medication errors in Pakistan

How fatal are medication errors worldwide, and in Pakistan? | How to avoid these.

Nearly everyone, especially in Pakistan has gone through, bad experiences in the health sector. Things like the wrong diagnosis, disasters due to doctors’ negligence – even if it is bad handwriting, ill prescription, false mention of dose timings so on and so forth. These kinds of instances are prevalent among government hospitals. Though these ill practices are present worldwide, in Pakistan, these are up to an alarming frequency. Just to quote one instance, Umer Farooq Bajwa died at Sheikh Zaid Hospital due to a medication error during his liver transplant.

There are innumerable cases of such treatments. The irony is most of these can be avoided without any excessive measure.

What is a Medical Error?

Simply put, a medication error is a difference between what the doctor intended and what he carried forward. In this definition, the quacks haven’t been considered because the whole treatment of quacks is a medication error since they don’t know what they are doing most of the time. A scholarly definition is given by Grober and Bohnen which says that a medical error is “the failure of a planned action to be completed as intended (an error of execution) or the use of a wrong plan to achieve an aim (an error of planning) (Reason, 1990). An unintended act (either of omission or commission) or one that does not achieve its intended outcome (Leape, 1994). Deviations from the process of care, which may or may not cause harm to the patient (Reason, 2001).”

Types of Medical Errors

There are several types of medication errors. One problem in listing down all of these is that in different situations, certain kinds of error might or might not occur. For example, while using a digital platform for medicine management (like EMR or EHR), there are far fewer chances of the wrong prescriptions in terms of handwriting (as doctors are notorious for their handwriting). But just to name a few, the following is the list based on a study done by US National Library of Medicine and National Institute of Health:

Diagnostic

  • Error or delay in diagnosis
  • Failure to employ indicated tests
  • Use of outmoded tests or therapy
  • Failure to act on results of monitoring or testing

Treatment

  • Error in performance of an operation, procedure, or test
  • Error in administering treatment
  • Error in the dose or method of using a drug
  • Avoidable delay in treatment or in responding to an abnormal test
  • Inappropriate care

Preventive

  • Failure to provide prophylactic treatment
  • Inadequate monitoring or follow-up of treatment

Other

  • Failure of communication
  • Equipment failure
  • Other system failures

Medical Errors around the world

As said before, medication errors are prevalent all around the world. In the US, 1.3 million people are injured annually due to medication errors. Around 9,000 to 24,000 people die annually in Canada. due to negligence of hospital administration. According to a study by the European Commission, the prevalence of medication errors in Latvia is 32%, in Denmark, it is 29%, and in Poland, it is 28%. Journal of Anesthesiology reports that in India, medication errors occur around 5.2 million times annually. And only in Delhi, 82 out of every thousand prescriptions contain an error.

 

Medical Errors in Pakistan

According to a study done by the Journal of Pakistan Medical Association, quotes a prescription error of 39.28%. It is found that 5.5% of pharmacists, 2.6% nurses, and 1.1% of physicians are negligent towards their practices.

Only a handful of medical errors get attention in our media. And in fact, thousands of cases go without the attention of even the patient himself. No one will question that the deterioration of their health even after a check-up by a doctor, can be the result of a medication error. People make statements like this doctor doesn’t have shifa and that’s all.

Only a handful of people understand that the negligence of the system could result in this unfortunate event, not the doctor himself. Abdul Latif Shaikh, president of the Pakistan Society of Health-System Pharmacists (PSHP), quoted that 5,00,000 people die annually due to some kind of medication error in Pakistan.

Can we avoid Medical Errors?

These errors cannot be removed over nightly but can be reduced significantly in a day just by employing a reliable and efficient Electronic Management Record system (EMR). By using an EMR, issues like prescription errors, dosage errors, and wrong diagnosis will be reduced considerably. Plus, the efficiency that comes is additional. A lot of errors occur because of the workload on doctors. When an EMR will share their managerial workload, they will be easily able to put more effort into diagnosis and spend more time with the patient. And hopefully, save a few beautiful lives.

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