Physicians' adherence to evidence‐based guidelines as a major predictor of anticoagulant‐related medication error incidence and severity.

Aims: Anticoagulants represent a main source of medication errors (MEs) and complications that have catastrophic implications, posing an obligation on health care providers to assess anticoagulant‐related MEs and factors affecting their occurrence. This study investigates the occurrence and severity of prescribing MEs in patients on anticoagulants and explores their potential predictors. Methods: This study was a prospective cohort study in a tertiary hospital on 116 patients with a total of 2166 anticoagulant doses. Results: Forty‐four percent of prescribed anticoagulant doses resulted in MEs with low molecular weight heparin (LMWH) and unfractionated heparin (UFH) causing 61% and 34%, respectively, of the total MEs. More than 50% of all MEs were incorrect doses (high and low) shared between heparin and tinzaparin. The highest severity of error was Category D followed by Category F and Category C. A Poisson regression analysis model revealed that female (incidence rate ratio [IRR] 1.32, 95% confidence interval [CI] 1.13–1.54, P <.001), bridging (IRR 1.52; 95% CI 1.10–2.09; P =.011), venous thromboembolism (VTE) prophylaxis (IRR 7.65; 95% CI 4.88–12.02; P <.001), physician non‐adherence (IRR 2.71; 95% CI 2.22–3.29; P <.001), and polypharmacy (IRR 1.68; 95% CI 1.26–2.23; P =.036) were predictors of the higher incidence of MEs. Ordinal logistic regression analysis demonstrated that physician non‐adherence (OR 24.67; 95% CI 5.54–207; P <.001) was the main predictor of increased error severity. Conclusion: The major predictor in increasing both the incidence and severity of MEs is physician adherence to evidence‐based guidelines (EBG). Strict regulations for anticoagulant prescribing through an anticoagulant stewardship program are a necessity. [ABSTRACT FROM AUTHOR]