ABSTRACT:

Prescribing errors are a major concern in the healthcare system, particularly in low- to middle-income countries. Nutritional therapies are increasingly included in prescriptions without adequate assessment. These errors pose significant risks to patient health, leading to increased pharmacoeconomic burdens and potential harm. This study aimed to evaluate the prevalence and nature of prescribing errors, with a particular focus on the inclusion and appropriateness of nutritional therapies in outpatient settings. A sample of 400 prescriptions was selected based on convenience sampling from outpatient pharmacies over a six-month period (September 2024 – February 2025). Prescriptions were evaluated using a checklist to identify omission (missing information) and commission (incorrect information) errors. The checklist was constructed with a scoring method (any missing or error was scored as 1). Twenty-eight prescriptions (7.0%) were excluded from the study due to illegible writing. Among omission errors, the lack of authentication of prescriptions was observed, including prescribers’ registration numbers (93.27%) and prescribers’ qualification details (63.70%). While in commission errors, drug-drug interactions (66.93%), wrong strength (27.41%), and wrong frequency of medication (19.08%) were the major highlights. Of the 372 eligible prescriptions, 77% contained omission errors, and 23% had commission errors. Notably, nutritional supplements were prescribed in 28% (n = 104) of cases, including various vitamins (B-complexes and vitamin D), calcium, folic acid, zinc, and other minerals. Drug-drug interactions were observed in 67% (n = 249), including serious and avoidable combinations. Based on the findings, it is concluded that the high rate of prescribing errors and unchecked inclusion of nutritional supplements reflect systemic gaps in prescription practices. The implementation of technology, such as a CPOE (Computerized Physician Order Entry) system, to replace non-standardized handwritten prescriptions is an urgent need of the time. Furthermore, pharmacist involvement is recommended, alongside more cautious use of nutritional therapies.

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