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Official websites use. Share sensitive information only on official, secure websites. Correspondence to Dr Abdallah Y Naser; abdallah. To explore the correlation between prescribing rate of medications and hospital admissions related to medications administration errors in England and Wales during the time from to A population-based study using hospital admission data that are publicly available in the UK. The Prescription Cost Analysis database was used to extract the prescription data. Hospitalisation rates related to medication administration errors and its associated prescriptions. The annual rate of hospital admissions related to medication administration errors increased by The most common three indications of hospital admissions were T39 non-opioid analgesics, antipyretics and antirheumatics , T43 psychotropic drugs , T42 antiepileptic, sedative-hypnotic and antiparkinsonism drugs. The age group 15—59 years had the highest number of hospital admissions Women contributed to Admission rate among men increased by Among women, the admission rate increased by Admission rates due to medication administration errors increased markedly in the past decade. This increase was correlated with an increase in the prescription rate of several therapeutic classes. Patients taking non-opioid analgesics, antipyretics and antirheumatics, psychiatric medications, antiepileptic, sedative-hypnotic and antiparkinsonism drugs should have their recommended and administered doses closely monitored. They should be followed up on a regular basis to ensure that they are taking their medications as prescribed. This study investigated the hospitalisation patterns related to medication administration errors and their corresponding prescription rates between the years and Ecological studies serve as a valuable tool in the generation of hypotheses and the identification of potential associations between variables. The utilisation of population-level aggregated data posed limitations in our ability to conduct patient follow-ups and identify significant confounding factors. The utilisation of aggregated data limited the capacity to access crucial patient demographic information, including comorbidities and ethnicity. Medicines are widely used to provide the best medical care to patients, which contributes to improving the health of the community. These errors affect the desired results of treatment, especially since some of these errors can be preventable. Medication administration errors are one of the common causes of medical emergencies. Therefore, knowing the causes, leading to drug poisoning and preventing them and knowing the drug categories related to drug poisoning and putting more restrictions on it could contribute to reducing poisoning cases, reducing economic costs and improving community health. A previous study by Al-Daghastani and Naser has explored the trend of hospital admission due to poisoning by psychotropic drugs and prescriptions of psychotropic medications in England and Wales and found a very strongly and positive correlation between the hospital admission rate with the overall poisoning by psychotropic drugs. Therefore, the aim of this research is to explore the correlation between prescribing rate of medications and hospital admissions related to medication administration errors in England and Wales during the time from to An ecological study was conducted using hospital admission data that are publicly available in the UK. Hospital episodes' statistics database contains all details of all patient admissions, outpatient, and appointment attendances at National Health Services hospitals in England. Patient Episode Database in Wales contains all patient activity in Wales. These two databases contain all hospital admission data for patients who suffer from medication administration errors, categorised by age groups into four groups: less than 15 years, from 15 to 59 years, from 60 to 74 years and 75 years and above. The tenth edition of the International Statistical Classification of Diseases was used to identify medication administration error admissions. Data are aggregated by calendar year and by month. This database contains prescription data that has already been dispensed into the community. The prescriptions that were written and not dispensed were not included. Data are available for the period from April onwards. Medication administration errors included poisoning by, adverse effect of and underdosing of medications. Prescription-related rates were also calculated by dividing the number of prescriptions per drug class by the total mid-year population during the same year. The correlation between hospital admission rates for medication administration errors and its related medication prescribing rates was assessed for the duration between and using the Pearson correlation coefficient. The annual rate of hospital admissions related to MEs increased by The most common three indications of hospital admissions related to ME causes were T39 non-opioid analgesics, antipyretics and antirheumatics , T43 psychotropic drugs, not elsewhere classified , T42 antiepileptic, sedative-hypnotic and antiparkinsonism drugs table 1. Percentage of hospital admissions related to medication errors from the total number of admissions. Over 21 years from to , T41 anaesthetics and therapeutic gases , T38 hormones and their synthetic substitutes and antagonists, not elsewhere classified and T40 narcotics and psycholeptics hallucinogens showed the highest increase in the rate of annual hospital admissions related to MEs, which increased fourfolds, Oppositely, T48 agents primarily acting on smooth and skeletal muscles and the respiratory system , T50 diuretics and other and unspecified drugs, medicaments and biological substances and T37 other systemic anti-infectives and antiparasitics showed the highest decrease in the rate of annual hospital admissions related to MEs, which decreased by Percentage change in admissions related to medication errors rates in England and Wales from to Hospital admission rates for medication administration errors of drugs medicaments in England and Wales between and According to the age groups, our results showed that the age group 15—59 years had the highest number of hospital admissions related to MEs with The hospital admissions rate related to MEs for the age group below 15 years decreased by For the age group 15—59 years, the admission rate increased by The admissions rate for the age group 60—74 years increased by For the age group 75 and above years, the admission rate increased by Admissions rate among men increased by A total of 15 prescriptions were dispensed in England and Wales from to , where the absolute number of prescriptions dispensed annually increased by England and Wales medication prescription rate increased by Despite genetic and ethnic differences between people which may affect their response to medications, failure of therapy may result in errors and damages that cause an increase in hospital admission rates. Medicines such as cyclosporine, digoxin, aminoglycosides, carbamazepine, digitoxin, lithium, flecainide, phenytoin, rifampicin, phenobarbital, warfarin and theophylline are considered to be having a narrow therapeutic window. Elderly are prone to several diseases and comorbidities, which may necessitate taking several medications together and this by itself is a major risk factor that complicates their health status and compromises their medication compliance. In this study, the most common three groups of medications that cause hospital admissions related to MEs were T39 non-opioid analgesics, antipyretics and antirheumatics , T43 psychotropic drugs, not elsewhere classified and T42 antiepileptic, sedative-hypnotic and antiparkinsonism drugs. Non-opioid analgesics are used in the treatment of acute or chronic pain, for example, in the elderly or in patients with cardiovascular diseases suffering from accompanying pain, which calls for the use of analgesics. Psychotropic drugs have serious side effects and can interfere with many medications. These drugs are used more often by the elderly and may be part of their polypharmacy, which increases the possibility of drug—drug interactions. In two studies conducted in a teaching hospital by Bates et al , and Lesar and colleagues, 1. These medicines have multiple harmful side effects, such as hip fractures, falls, cognitive disability and impairment especially in the elderly. T41 anaesthetics and therapeutic gases , T38 hormones and their synthetic substitutes and antagonists, not elsewhere classified and T40 narcotics and psycholeptics hallucinogens showed the highest increase in the rate of annual hospital admissions related to MEs, which increased fourfolds, Anaesthetics and therapeutic gases are used during various operations. The study of Becker and Rosenberg reported that the use of anaesthetic agents, such as anaesthetic gases, has increased, especially in the emergency department and dental clinics. Its use in patients who may suffer from mental illnesses such as schizophrenia and who use medications that may interfere with these agents or in pregnant women may cause unwanted results and harm. In a study conducted from to in the USA, the rate of errors related to insulin increased by almost fivefolds. T48 agents primarily acting on smooth and skeletal muscles and the respiratory system , T50 diuretics and other and unspecified drugs, medicaments and biological substances and T37 other systemic anti-infectives and antiparasitics showed the highest decrease in the rate of annual hospital admissions related to MEs, which decreased by The increase in using antibiotics and the subsequent increase in antibiotic resistance have led to the development of strategies and guidelines for the proper selection of antibiotics. This has resulted in reducing the prevalence of antibiotic dispensing, antibiotic resistance and, thus, the hospital admissions related to MEs. In this study, the age group 15—59 years had the highest number of hospital admissions related to MEs with The age group from 15 to 59 included the largest number of patients, which caused an increase in errors and complications or poisoning that lead to more hospital admissions related to these errors. Drug abuse is a phenomenon that exists all over the world. According to a study done by Bennett, the onset of drug abuse begins at the adolescent age of 16 years. An increase in the misuse of prescription opioids was observed in England, Wales and Scotland from to This decrease is due to demographic change and the high rates of geriatric population in the United Kingdom, which alerted decision-makers to give special attention to health issues related to the geriatric population, such as chronic diseases, which contributed to this decrease. Women encounter more side effects than men. This could be due to physiological, pharmacokinetic and genetic differences between the two genders. In addition, many medications are dispensed only to women such as certain hormones, contraceptives and pregnancy-related drugs. The hospital admissions related to MEs rate in men increased by On the other hand, the hospital admissions related to MEs rate in women increased by Some medications dispensed during pregnancy, such as nutritional supplements or antinausea drugs, led to an increase in the rates of drug dispensing in women than in men. Also, some diseases are more prevalent in women than men, such as thyroid diseases, breast and cervical cancers, musculoskeletal disorders and gynaecological infections, which increases the need to dispense more medicines, which in turn may cause complications and errors that cause an increase in hospital admission rates. Healthcare policymakers in the United Kingdom are recommended to give higher priority and place more emphasis on geriatric healthcare, restricting the use of antibiotics in the community, activating the antimicrobial stewardship programmes in the institutions as well as placing more control on the use of non-steroidal anti-inflammatory drugs due to their side effects, especially in geriatric populations who may have impaired kidney function. Healthcare professionals need to evaluate and enhance medication administration protocols within healthcare facilities with the aim of reducing the likelihood of MEs. Additionally, they should foster a culture that promotes the reporting and learning from MEs. Furthermore, the implementation of electronic health records and clinical decision support systems can aid healthcare providers in making informed decisions regarding medication. To the best of our knowledge, this is the first study to explore the trend of hospital admissions related to all medication administration errors in the UK. This research provided a comprehensive analysis of the trend of hospital admission in the past 21 years — In addition, this research explored the correlation between this type of hospital admission and their associated prescription rates. At the same time, this type of research has limitations. The ecological study design utilising aggregated data on the population level did not allow us to explore associations, follow-up with the patients or identify important confounding factors that could have affected the admission rates. We were unable to explore important demographic information related to the patients including comorbidities, ethnicity and smoking status. Our admission rates might include readmission episodes, which might have led to overestimation. Therefore, our findings should be interpreted carefully. Admission rates due to medication administration errors increased markedly in the past decades. Patients aged 15—59 should receive more instruction on how to properly use their medications. When prescribing or administering high-risk drugs to high-risk patients, healthcare providers should take caution. Contributors: Contributed to conception and design: AYN. Revising the paper for important intellectual content; final approval of the version submitted; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: all authors. All authors have read and approved the manuscript. AYN act as guarantor for the work and the conduct of the study, had access to the data, and controlled the decision to publish. Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Supplemental material: This content has been supplied by the author s. Any opinions or recommendations discussed are solely those of the author s and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Data are available in a public, open access repository. Publicly available datasets were analysed in this study. Therefore, it was considered an exempt category. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. BMJ Open. Find articles by Oudai Amjad Al Shoaraa. Find articles by Sami Qadus. Find articles by Abdallah Y Naser. No commercial re-use. See rights and permissions. Published by BMJ. Open in a new tab. Percentage change in medication prescription rates in England and Wales from to Provenance and peer review: Not commissioned; externally peer reviewed. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Other systemic anti-infectives and antiparasitics. Hormones and their synthetic substitutes and antagonists, not elsewhere classified. Non-opioid analgesics, antipyretics and antirheumatics. Antiepileptic, sedative-hypnotic and antiparkinsonism drugs. Drugs primarily affecting the autonomic nervous system. Primarily systemic and haematological agents, not elsewhere classified. Agents primarily affecting the cardiovascular system. Agents primarily affecting the gastrointestinal system. Agents primarily acting on smooth and skeletal muscles and the respiratory system. Topical agents primarily affecting skin and mucous membrane and by ophthalmological, otorhinolaryngological and dental drugs. Diuretics and other and unspecified drugs, medicaments and biological substances. Narcotics and psychodysleptics hallucinogens. Obstetrics, gynaecology and urinary tract disorders.

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