Incidence, nature, severity, and causes of dispensing errors in community pharmacies in Jordan

BackgroundMedication dispensing is a core function of community pharmacies, and errors that occur during the dispensing process are a major concern for pharmacy profession. However, to date there has been no national study of medication dispensing errors in Jordan.ObjectiveThe study aimed to investigate the incidence, nature, severity, causes and predictors of medication dispensing errors.SettingThe study was conducted in randomly selected community pharmacies across Jordan.MethodA mixed method approach was taken, incorporating prospective disguised observation of dispensing errors and interviews with pharmacists regarding the causes of errors. A multidisciplinary committee evaluated the severity of errors. Proportionate random sampling was used to include 350 pharmacies from across all regions of Jordan. SPSS (Version 24) was used for data analysis.Main outcome measureIncidence, nature, severity, causes and predictors of medication dispensing errors.ResultsThe overall rate of medication dispensing errors was 24.6% (n = 37,009/150,442), of which 11.5% (n = 17,352/150,442) were prescription related errors and 13.1% (n = 19,657/150,442) pharmacist counselling errors. The most common type of prescription-related errors were wrong quantity (37.9%, n = 6584/17,352), whereas the most common pharmacist counselling error was wrong drug (41.9%, n = 8241/19,657). The majority of errors were caused by poor handwriting (30.7%, n = 75,651/37,009), followed by high workload (17.3%, n = 22,964/37,009). More than half of errors (52.6%) were moderate in severity, followed by minor errors (38.8%), and 8.6% of errors were rated as serious. Predictors of medication dispensing errors were: Sundays (OR 2.7; 95% CI 2.15-3.94;p = 0.02), grade A pharmacies (dispensing >= 60 prescriptions a day (OR 3.6; 95% CI 2.89-4.78;p = 0.04)), and prescriptions containing >= 4 medication orders (OR 4.1; 95% CI 2.9-6.4;p = 0.001).ConclusionMedication dispensing errors are common in Jordan and our findings can be generalised and considered as a reference to launch training programmes on safe medication dispensing and independent prescribing for pharmacists.