PMID- 35293625
OWN - NLM
STAT- MEDLINE
DCOM- 20220719
LR  - 20220728
IS  - 1365-2125 (Electronic)
IS  - 0306-5251 (Linking)
VI  - 88
IP  - 8
DP  - 2022 Aug
TI  - Physicians' adherence to evidence-based guidelines as a major predictor of 
      anticoagulant-related medication error incidence and severity.
PG  - 3730-3740
LID - 10.1111/bcp.15314 [doi]
AB  - AIMS: Anticoagulants represent a main source of medication errors (MEs) and 
      complications that have catastrophic implications, posing an obligation on health 
      care providers to assess anticoagulant-related MEs and factors affecting their 
      occurrence. This study investigates the occurrence and severity of prescribing 
      MEs in patients on anticoagulants and explores their potential predictors. 
      METHODS: This study was a prospective cohort study in a tertiary hospital on 116 
      patients with a total of 2166 anticoagulant doses. RESULTS: Forty-four percent of 
      prescribed anticoagulant doses resulted in MEs with low molecular weight heparin 
      (LMWH) and unfractionated heparin (UFH) causing 61% and 34%, respectively, of the 
      total MEs. More than 50% of all MEs were incorrect doses (high and low) shared 
      between heparin and tinzaparin. The highest severity of error was Category D 
      followed by Category F and Category C. A Poisson regression analysis model 
      revealed that female (incidence rate ratio [IRR] 1.32, 95% confidence interval 
      [CI] 1.13-1.54, P < .001), bridging (IRR 1.52; 95% CI 1.10-2.09; P = .011), 
      venous thromboembolism (VTE) prophylaxis (IRR 7.65; 95% CI 4.88-12.02; P < .001), 
      physician non-adherence (IRR 2.71; 95% CI 2.22-3.29; P < .001), and polypharmacy 
      (IRR 1.68; 95% CI 1.26-2.23; P = .036) were predictors of the higher incidence of 
      MEs. Ordinal logistic regression analysis demonstrated that physician 
      non-adherence (OR 24.67; 95% CI 5.54-207; P < .001) was the main predictor of 
      increased error severity. CONCLUSION: The major predictor in increasing both the 
      incidence and severity of MEs is physician adherence to evidence-based guidelines 
      (EBG). Strict regulations for anticoagulant prescribing through an anticoagulant 
      stewardship program are a necessity.
CI  - (c) 2022 British Pharmacological Society.
FAU - El-Bosily, Heba M
AU  - El-Bosily HM
AD  - Clinical Pharmacy Department, El-Sheikh Zayed Specialized Hospital, Giza, Egypt.
FAU - Abd El Meguid, Khaled R
AU  - Abd El Meguid KR
AD  - Cardiology Department, Faculty of Medicine, Beni-suef University, Beni-suef, 
      Egypt.
FAU - Sabri, Nagwa A
AU  - Sabri NA
AD  - Clinical Pharmacy Department, Faculty of Pharmacy, Ain-Shams University, Cairo, 
      Egypt.
FAU - Ahmed, Marwa Adel
AU  - Ahmed MA
AUID- ORCID: 0000-0002-5193-9523
AD  - Clinical Pharmacy Department, Faculty of Pharmacy, Ain-Shams University, Cairo, 
      Egypt.
LA  - eng
PT  - Journal Article
DEP - 20220329
PL  - England
TA  - Br J Clin Pharmacol
JT  - British journal of clinical pharmacology
JID - 7503323
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/adverse effects
MH  - Female
MH  - Heparin/adverse effects
MH  - Heparin, Low-Molecular-Weight/adverse effects
MH  - Humans
MH  - Incidence
MH  - Medication Errors/prevention & control
MH  - *Physicians
MH  - Prospective Studies
MH  - *Venous Thromboembolism/prevention & control
OTO - NOTNLM
OT  - Egypt
OT  - adverse drug events
OT  - anticoagulant
OT  - clinical pharmacy
OT  - guideline adherence
OT  - medication error
OT  - prescribing errors
EDAT- 2022/03/17 06:00
MHDA- 2022/07/20 06:00
CRDT- 2022/03/16 08:45
PHST- 2022/01/16 00:00 [revised]
PHST- 2021/09/25 00:00 [received]
PHST- 2022/03/01 00:00 [accepted]
PHST- 2022/03/17 06:00 [pubmed]
PHST- 2022/07/20 06:00 [medline]
PHST- 2022/03/16 08:45 [entrez]
AID - 10.1111/bcp.15314 [doi]
PST - ppublish
SO  - Br J Clin Pharmacol. 2022 Aug;88(8):3730-3740. doi: 10.1111/bcp.15314. Epub 2022 
      Mar 29.