Physician Adherence to Treatment Guidelines and the Incidence of Prescribing Errors for Patients in Intensive and Cardiac Care Units at a Teaching Hospital, Al-Muthanna City, Iraq: A Retrospective Analysis

Background: Prescribing errors are common worldwide. They are exposing critically ill patients to increased morbidity and mortality and overwhelming healthcare systems. Limited data exist on the prevalence of prescribing errors for critically ill patients in Iraq. Objectives: To assess the prevalence and types of prescribing errors in the Cardiac and Intensive Care Units in Iraq. Methods: A retrospective study was conducted at a teaching hospital in Al-Muthanna, Iraq. Charts of patients admitted to the Cardiac and Intensive Care Units for at least one day between January and June 2024 were included, excluding those without a diagnosis. To detect prescribing errors, the latest American guidelines, the British National Formulary, and Medscape were used. Results: Out of 239 charts included, 107 showed prescribing errors. Patients were prescribed 7.66±2.32 medications. Meanwhile, 2.29±1.17 of them contain an error. Omission of indicated medications (81.3%) and dosing errors (43%) were detected due to non-adherence to treatment guidelines. Lack of monitoring for prescribed medications (59.8%) and prescribing drug-drug interactions (31.8%) were also common. The number of diseases and renal impairments was positively correlated with the frequency of errors. Patient age, medical history, renal function, number of medications, and errors didn't significantly impact patients' mortality. Conclusions: Prescribing errors are prevalent in the cardiac ICU, mainly due to poor adherence to treatment guidelines. Despite the presence of errors, no significant relationship was reported between prescribing errors and patients' mortality.