Outcomes of measures to prevent dose selection errors (2023-2024)
- VernacularTitle:Эмийн тун сонголтын алдаанаас сэргийлэх арга хэмжээний үр дүн (2023-2024)
- Author:
Nomin-Erdene Ts
1
;
Tserennyam D
1
;
Delgermaa Ts
2
;
Orgilmaa Ts
2
;
Mungunchimeg M
2
;
Khulan M
2
;
Khulan A
2
;
Nina M
1
;
Erdenetuya M
1
Author Information
1. School of Pharmacy, MNUMS
2. Mongolian Japanese Hospital, Department of Pharmacy, MNUMS
- Publication Type:Journal Article
- Keywords:
medication review, pharmacist recommendation, dose adjustment, medication safety
- From:
Mongolian Journal of Health Sciences
2025;87(3):154-160
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:A drug related problem is defined by the Pharmaceutical Care
Network Europe Association as an an event or circumstance involving drug
therapy that actually or potentially interferes with desired health outcomes.
One critical aspect of preventing such errors is proper dose adjustment, which
plays a vital role in the diagnosis and treatment of disease. For instance, adjusting
the dose of warfarin based on the patient’s INR level is essential. In
a 1995 study conducted in England, clinical pharmacists recommended target
doses of angiotensin-converting enzyme (ACE) inhibitors for patients with
chronic heart failure. As a result, patients experienced a significant reduction
in pulmonary and peripheral edema, along with improved exercise test outcomes.
At the Mongolian-Japanese Hospital of the Mongolian Medical University
of Science and Technology, it is important to analyze dosage-related
issues identified by clinical pharmacists and inform healthcare professionals
about common dosage selection errors and associated risks.
Aim:We analyzed issues related to medication dosage.
Materials and Methods:A retrospective study was conducted to examine
problem related to dosage detected through prescription monitoring at the
Mongolian Japanese Hospital of the Mongolian National University of Health
Sciences from 2023 to 2024.
Results:Out of a total of 2340 drug-related problem identified across five
inpatient wards during this period, 581 (100%) were related to dosage. Clinical
pharmacists performed prescription review on approximately 67% of all
inpatients, which was consistent between years. However, medication-related
problems tended to decrease from 41.1% (n=1499) in 2023 to 22.3% (n=841)
in 2024 (p=0.05). The majority of dose-related problems, 75.6% (n=440), were
overdoses. Medication-related problems were most common in the surgical
department, with 59.5% (n=346) (p=0.001). The most frequent dosage-related
errors involved exceeding the daily dose of diclofenac, administering higher-
than-recommended doses of ceftriaxone, failing to adjust cefotaxime for
renal function, and using inappropriate doses of metronidazole in patients with
impaired liver function. The leading cause of these errors was failure to adhere
to guideline-recommended dosing, which accounted for 71.3% (n=415)
of cases (p=0.001). When dosage-related recommendations were provided to
physicians before of treatment, acceptance rates increased by 14% (p=0.001).
These interventions resulted in an estimated cost saving of 1.267.219₮ and a
reduction of 363 injections.
Conclusion:Therefore, clinical pharmacist-led prescription review can help
reduce the risk of dosage errors, lower associated healthcare costs, and alleviate
the burden on medical staff.
- Full text:2025052421244102291154-160.pdf
