A study on prescribing errors in in-patients of a corporate tertiary care hospital in North India

Ashish Yadav, Mohammed R. Rashed


Background: Prescribing errors are a subset of medication errors which have a potential for grave harm to the patient. Identification and acknowledgement of such errors can ameliorate much of this danger. Studies of prescribing errors are sparse in India. Such studies, whatever have been conducted, mainly focus on the out-patients or the patients on discharge. Hence, this study was undertaken to study the prescribing errors in prescriptions generated for patients admitted in wards of a corporate hospital in North India.

Methods: The prescriptions for in-patients admitted in wards were analyzed for different types of prescribing errors in individual drug orders and prescription as a whole.

Results: The prescribing error rate was found to be 3.3% in this study. Of all errors, errors leading to delays in patient care (i.e. Errors of prescription writing) (54.54%) and erroneous copying of the prescription to the drug chart by junior/ resident doctors (Transcription errors) (31.31%) were found to be the major causes of prescribing errors in this study. Of the former category, prescribing a wrong strength (24.24%) and illegible drug orders (12.12%) were the most numerous error subtypes. Errors leading to sub-optimal patient care (i.e. Errors of decision making) were least identified of which Therapeutic duplication (12.12%) was the most common subtype.

Conclusions: The error rate found in this study is comparable to the data available from developed countries. However, there are significant differences in the occurrences of error subtypes found in this study as compared to the studies of the west.


Indian, In-patients, Medication errors, Prescribing errors, Prescription errors, Transcription errors

Full Text:



Dean B, Schachter M, Vincent C, Barber N. Prescribing errors in hospital inpatients: their incidence and clinical significance. Qual Saf Health Care. 2002 Dec;11(4):340-4.

WHO. The third WHO Global Patient Safety Challenge: Medication Without Harm [Internet]. WHO. Available at: 18 May 2019.

Folli HL, Poole RL, Benitz WE, Russo JC. Medication error prevention by clinical pharmacists in two children's hospitals. Pediatr. 1987 May 1;79(5):718-22.

Blum KV, Abel SR, Urbanski CJ, Pierce JM. Medication error prevention by pharmacists. Am J Hosp Pharm. 1988 Sep 1;45(9):1902-3.

Lesar TS, Briceland L, Stein DS. Factors related to errors in medication prescribing. JAMA. 1997 Jan 22;277(4):312-7.

An in Depth Investigation into Causes of Prescribing Errors by Foundation Trainees in Relation to Their Medical Education EQUIP Study. AHRQ Patient Safety Network. Available at: 18 May 2019.

Franklin BD, Reynolds M, Shebl NA, Burnett S, Jacklin A. Prescribing errors in hospital inpatients: a three-centre study of their prevalence, types and causes. Postgrad Med J. 2011 Nov 1;87(1033):739-45.

Ryan C, Ross S, Davey P, Duncan EM, Francis JJ, Fielding S, et al. Prevalence and Causes of Prescribing Errors: The PRescribing Outcomes for Trainee Doctors Engaged in Clinical Training (PROTECT) Study. Berthold HK, editor. PLoS ONE. 2014 Jan 3;9(1):e79802.

Seden K, Kirkham JJ, Kennedy T, Lloyd M, James S, Mcmanus A, et al. Cross-sectional study of prescribing errors in patients admitted to nine hospitals across North West England. BMJ Open. 2013;3(1):e002036.

Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, et al. The Costs of Adverse Drug Events in Hospitalized Patients. JAMA. 1997 Jan 22;277(4):307-11.

Elliot R.A., Camacho E., Campbell F., Jankovic D., James M.M.S., Kaltenthaler E, et al. Prevalence and economic burden of medication errors in the NHS in England. Available at: 18 May 2019.

Mohan P, Sharma AK, Panwar SS. Identification and quantification of prescription errors. Med J Armed Forces Ind. 2014 Apr;70(2):149-53.

Shelat PR, Kumbar SK. Analysis of Outdoor Patients’ Prescriptions According to World Health Organization (WHO) Prescribing Indicators Among Private Hospitals in Western India. J Clin Diagn Res. 2015 Mar;9(3):FC01-4.

Dean B, Schachter M, Vincent C, Barber N. Prescribing errors in hospital inpatients: their incidence and clinical significance. Qual Saf Health Care. 2002 Dec;11(4):340-4.

Franklin BD, Puaar S. What is the impact of introducing inpatient electronic prescribing on prescribing errors? A naturalistic stepped wedge study in an English teaching hospital. Health Informatics J. 2019 Mar 18;146045821983311.

Ridley SA, Booth SA, Thompson CM, Intensive Care Society’s Working Group on Adverse Incidents. Prescription errors in UK critical care units. Anaesthesia. 2004 Dec;59(12):1193-200.

Hitti E, Tamim H, Bakhti R, Zebian D, Mufarrij A. Impact of Internally Developed Electronic Prescription on Prescribing Errors at Discharge from the Emergency Department. West J EM. 2017 Aug 7;18(5):943-50.

Alvarado AC, Ossa GX, Bustos ML. Errores en las recetas médicas y en la preparación de estas en farmacia de pacientes ambulatorios: El caso del Hospital de Nueva Imperial. Rev méd Chile. 2017 Jan;145(1):33-40.

Babatunde KM, Akinbodewa AA, Akinboye AO, Adejumo AO. Prevalence and pattern of prescription errors in a Nigerian kidney hospital. Ghana Med J. 2016 Jan 16;50(4):233.