Publication: Trends of medication errors and its associated factors in Malaysia: an analysis from the medication error reporting system, 2016-2023
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Date
2024-12
Authors
Azlan, Wan Mastura Wan Mohamad
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Abstract
Introduction: Assessing factors contributing to medication errors is crucial in healthcare settings, particularly in Malaysia, where medication errors lead to significant patient harm, prolonged hospital stays, increased healthcare costs and even fatalities. This study aimed to describe the trend of medication errors in Malaysia from 2016 to 2023 and to identify associated factors (staff-related factors, medication-related factors, task or technology-related factors, work or environment-related factors, time and location of events) that affected the number of medication errors in Malaysia. Method: A cross-sectional study was conducted using secondary data from the National Medication Error Reporting System (MERS) from January 2016 until December 2023. Cases that met the inclusion criteria, involving medication error reportsِ fromِ Malaysia’sِ governmentِ hospitalsِ andِ clinics,ِ wereِ included,ِ whileِ thoseِ
with over 20% missing data for relevant variables were excluded. Medication error trends were analyzed using Joinpoint regression, and associated factors were examined using Poisson regression analysis. Result: Out of 377,089 medication error reports obtained from the National Medication Error Reporting System (MERS) across Malaysia, a total of 372,916 reports qualified to be included and were analyzed in this study. The general characteristics of medication errors showed that the most frequent contributing factors were peak hours (24.9%), followed by distraction (20.2%) and inexperienced personnel (12.3%). The trend of medication error in Malaysia showed a significant increase from January 2016 to April 2021 (APC of 2.2%) but decreased
afterward (APC of -1.1%). The significant adjusted associated factors of medication errors were inexperienced personnel (Adj. IRR=1.02; 95% CI=1.01, 1.02), inadequate knowledge (Adj. IRR=1.03; 95% CI=1.02, 1.03), distraction (Adj. IRR=1.02; 95% CI=1.02, 1.03), sound alike medication (Adj. IRR=0.98; 95% CI=0.98, 0.99), heavy workload (Adj. IRR=1.02; 95% CI=1.02, 1.03), peak hour (Adj. IRR=1.02; 95% CI=1.01, 1.02), failure to adhere to work procedure (Adj. IRR=1.06; 95% CI=1.05, 1.06), patient information or record is unavailable or inaccurate (Adj. IRR=1.07; 95% CI=1.07, 1.08), incorrect computer entry (Adj. IRR=1.02; 95% CI=1.01, 1.02), other factors (Adj. IRR=1.03; 95% CI=1.02, 1.03), location of events in the emergency department (Adj. IRR=1.05; 95% CI=1.04, 1.05), in pharmacy (Adj. IRR=0.95; 95% CI=0.94, 0.95), in ward (Adj. IRR=1.01; 95% CI=1.01, 1.01), and in others (Adj. IRR=1.04; 95% CI=1.01, 1.06). Conclusion: The study revealed an overall increase in reported medication errors, with multiple contributing factors. Interventions targeting training for inexperienced personnel, minimizing distractions, and addressing workload during peak hours could enhance medication safety in Malaysia.