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Effectiveness of a pharmacist-led educational intervention to reduce the use of high-risk abbreviations in an acute care setting in Saudi Arabia: a quasi-experimental study
  1. Abdul Haseeb1,
  2. Win Winit-Watjana2,
  3. Abdul-Rahman R Bakhsh3,
  4. Mahmoud E Elrggal1,4,
  5. Muhammad Abdul Hadi1,
  6. Alaa A Mously5,
  7. Asmaa Z Gadibalban1,
  8. Bashayir F Al-Ibraheem6,
  9. Rasha A Almubark7,
  10. Rawan A Ekram1,
  11. Tahir Mehmood Khan8
  1. 1Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
  2. 2Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
  3. 3Ajyad Emergency Hospital, Ministry of Health, Makkah, Kingdom of Saudi Arabia
  4. 4Pharmaceutical research center, Deanship of Scientific research, Umm Al Qura University, Mecca, Kingdom of Saudi Arabia
  5. 5Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
  6. 6King Faisal Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
  7. 7Department of Preventive Medicines, University of Tennessee Health Science Center, University of Tennessee, Memphis, United States
  8. 8School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
  1. Correspondence to Dr Tahir Mehmood Khan; tahir.mehmood{at}


Objectives To evaluate the effectiveness of a pharmacist-led educational intervention to reduce the use of high-risk abbreviations (HRAs) by healthcare professionals.

Design Quasi-experimental study consisting of a single group before-and-after study design.

Setting A public emergency hospital in Mecca, Saudi Arabia.

Participants 660 (preintervention) and then 498 (postintervention) handwritten physician orders, medication administration records (MRAs) and pharmacy dispensing sheets of 482 and 388 patients, respectively, from emergency wards, inpatient settings and the pharmacy department were reviewed.

Intervention The intervention consisted of a series of interactive lectures delivered by an experienced clinical pharmacist to all hospital staff members and dissemination of educational tools (flash cards, printed list of HRAs, awareness posters) designed in line with the recommendations of the Institute for Safe Medical Practices and the US Food and Drug Administration. The duration of intervention was from April to May 2011.

Main outcome Reduction in the incidence of HRAs use from the preintervention to postintervention study period.

Findings The five most common abbreviations recorded prior to the interventions were ‘IJ for injection’ (28.6%), ‘SC for subcutaneous’ (17.4%), drug name and dose running together (9.7%), ‘OD for once daily’ (5.8%) and ‘D/C for discharge’ (4.3%). The incidence of the use of HRAs was highest in discharge prescriptions and dispensing records (72.7%) followed by prescriptions from in-patient wards (47.3%). After the intervention, the overall incidence of HRA was significantly reduced by 52% (ie, 53.6% vs 25.5%; p=0.001). In addition, there was a statistically significant reduction in the incidence of HRAs across all three settings: the pharmacy department (72.7% vs 39.3%), inpatient settings (47.3% vs 23.3%) and emergency wards (40.9% vs 10.7%).

Conclusions Pharmacist-led educational interventions can significantly reduce the use of HRAs by healthcare providers. Future research should investigate the long-term effectiveness of such educational interventions through a randomised controlled trial.

  • Clinical pharmacist
  • High-risk abbreviation
  • Educational intervention
  • Medication error
  • Prescribing practices

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