The Role Of Pharmacists In Improving Healthcare Outcomes: Analysis Of Interventions On Prescribing Errors In Malaysia

• By: TAN, Zhi Shan Sujata (Labuan Pharmaceutical Services Division, Ministry of Health Malaysia, Malaysia)
• Co-author(s): Mr Zhi Shan Sujata Tan (Labuan Pharmaceutical Services Division, Ministry of Health Malaysia, Labuan, Malaysia)
  Dr Siew Chin Ong (Discipline of Social and Administrative Pharmacy, Universiti Sains Malaysia, Penang, Malaysia)
  Dr Siok Yee Chan (Discipline of Pharmaceutical Technology, Universiti Sains Malaysia, Penang, Malaysia)
  
• Abstract:

  Background information:
  
  Prescribing errors (PE) are a major cause of avoidable harm in healthcare worldwide. In Malaysia, PEs are prevalent in government healthcare facilities. Pharmacists play a vital role in screening and intervening in prescriptions before dispensing medications. However, there is limited research at a national level investigating the relationship between the number of pharmacists and the total number of interventions conducted on prescribing errors as well as exploring the differences in the number of interventions across outpatient and inpatient setting.
  
  Purpose:
  
  This study aims to explore the relationship between the number of pharmacists and the total interventions on prescribing errors across different states and severity in Malaysia. Specifically, the trend of pharmacist and common types of instituted interventions on prescribing were focused, the impact of pharmacist and its role in various pharmacy settings.
  
  Method:
  A retrospective cross-sectional study analyzed data from the Ministry of Health's Pharmacy Management Form (PF form) and the Pharmacy Board Registry between 2017 and 2019. A multivariate regression analysis was conducted to determine the association between the number of pharmacists, total prescriptions received, and the number of prescribing errors intervened. A two-way ANOVA analysis was also performed to compare the number of pharmacist interventions for each type of prescribing error across three different settings: Health Clinic Outpatient Pharmacy, Hospital Outpatient Pharmacy, and Hospital Inpatient Pharmacy as well as severity levels.
  
  Results:
  
  Annually, a total mean of 1,355,170 (1.8% from total prescriptions received annually) pharmacists’ interventions on PEs were reported with wrong dose (n=308,549, 22.8%), wrong medication (n = 242,821, 17.9%) and wrong dosing frequency (n = 149,289, 11.0%) being top three PEs and is consistent across all three settings.
  
  The multivariate regression analysis revealed a significant positive association between the number of pharmacists, total prescriptions received, and the total interventions on PEs. The model's adjusted R-squared value of 0.899 suggests that the independent variables account for approximately 89.9% of the variability in the dependent variable with p-value of less than 0.05. Furthermore, the coefficients for the number of pharmacists and total prescriptions received are both significant (p<0.05) with positive values.
  
  The two-way ANOVA analysis revealed no statistically significant differences in the number of interventions due to either factor or their interaction. The lack of statistically significant differences in the number of interventions suggests that pharmacists consistently provide interventions for PEs across different settings and severity levels. This consistency indicates that pharmacists are playing an active role in addressing medication-related issues, regardless of the context or severity.
  
  Conclusion:
  
  This study demonstrates that an increasing number of pharmacists and total prescriptions received are significant predictors of an increased number of PEs intervened in Malaysia. The research provides valuable insights into the crucial role of pharmacists in mitigating prescription errors and improving overall patient safety and healthcare quality in Malaysia. The two-way ANOVA analysis highlights the versatility and adaptability of pharmacists, showing that they contribute to patient care in various settings and situations and can address diverse patient needs and provide interventions for PEs in different environments.