Objectives: To decide on whether tablet splitting scenarios represent prescribing error situations or not by a panel of expert judges composed of thirty members and to analyze splitting of tablets orders in two teaching hospitals.
Methods: A questionnaire containing scenarios was submitted to each member of the panel of expert judges, and a two round Delphi technique was followed to obtain consensus. Based on the Delphi rounds results, 902 and 316 medication orders were screened from Services hospital and Punjab Institute of Cardiology, respectively.
Results: Two scenarios were considered prescribing error situations, one was excluded and one was partially agreed upon. In Services Hospital 42 errors were detected, out of which 20 errors involved splitting of modified release tablets while 22 errors involved splitting of coated tablets. In Punjab Institute of Cardiology 41 errors were detected, out of which 23 errors involved splitting of modified release tablets while 18 errors involved splitting of coated tablets.
Conclusion: It was concluded that programs are needed to increase the current awareness regarding unsuitability of splitting all tablet types.
Patients suffer differential prescribing behavior as a function of their socioeconomic status. The current study was conducted in a qualitative and two observational phases in Lahore metropolitan area to investigate physician’s perspectives of patients’ socioeconomic status and the important indicators influencing prescribing behavior. Semi-structured interviews were conducted with physicians (N=20) from 2 hospitals, 2 diabetes care centers and 2 private clinics and scripts were analyzed for socioeconomic indicators. In the second phase, the opinions of a panel of prescribers (N=43) on the influence socioeconomic indicators on prescribing behavior were elicited. In the third phase a bipolar 5-point Likert rating scale was used to elicit the importance of indicators for physicians (N=100) originated from urban and rural areas. In the interviews physicians gave 15 potential socioeconomic indicators. Following the two Delphi rounds, consensus was reached on 11 (73.3%) of the indicators, the remaining 4 (26.7%) were highly disputable. Bivariate analysis showed that literacy, educational background, compliance, dress and appearance were important indicators at the time of clinical decision making for physicians originating from urban areas than for physicians originating from rural areas. Physicians originating from urban and rural areas perceived the socioeconomic status differently.