Abstract

INSULIN PRESCRIBING PRACTICES IN SAUDI ARABIA

Waleed M Al-shaqha*, Fuad A Al-Janabi, Anis Ahmad Chaudhary, Khalid M Alkharfy

ABSTRACT

To evaluate insulin prescribing practices in ambulatory care clinics at some hospitals in the Riyadh region, And Investigate some potential errors related to insulin prescriptions. A retrospective descriptive study that conducted over a period of 3 months at three different hospitals (MOH, military, and teaching) in Riyadh city. The aim is to collect prescriptions that include insulin as a prescribed medicine from the outpatient pharmacy. A data-collecting sheet designed to tabulate the Patient‟s demographics and define prescriber/setting characteristics will be used to collect pertinent information. Several categories in the prescription will specifically be investigated: 1) completeness of the patient‟s data that includes hospital name, patient name, MRN, date of birth, and diagnosis, and 2) insulin prescription content including writing illegibly, insulin name/type, non-standard nomenclature, dosage and direction, and an ambiguous medication order. A total of 1245 prescriptions were studied. The demographic of the patient observed in the prescription was 65.08% female and male 34.9%. For all prescription the prescriber was divided to tree categories; and the frequency was general practitioners 46.6%, specialist 47.3%, and consultants 6.1%. The hand writing clarity was 613 (49.2%) unclear prescription and 632 (50.8%) clear one. The study found that 59% of prescriptions without “unit” and 16% of prescriptions include the use of “U” and “IU” instead of “Units”. The most used insulin regimen was premixed insulin 70/30 (56.1%) followed by combination of Regular with NPH insulin (32.1%). Also Metformin was the most oral hypoglycemic drug prescribed with insulin (34.9%). And almost 94% of patients have HbA1C values greater than 6.5%. The results showed that important information is missing form many insulin prescriptions. Almost 50% of all of insulin prescriptions was deemed illegible. And there is some potential sources of errors in insulin prescriptions include the use of “U” and “IU” instead of “Units”. The data also show that the majority of patients have HbA1C values exceeding the target sated by international guidelines.

Keywords: Insulin, Diabetes Mellitus, Hypoglycemic Drug, Metformin, MRN