Common Prescription Errors in Diabetes: Physician’s Perspective

Abstract Background: Managing diabetes requires precise medication regimens, particularly with insulin and oral hypoglycemic agents (OHAs). However, prescription errors are prevalent in diabetes care and pose significant risks to patient safety, potentially resulting in severe acute and chronic complications. Despite the preventable nature of these errors, they persist in clinical practice, underscoring the need for improved prescribing practices and multidisciplinary care. Objective: This study aims to identify common prescription errors and faults in diabetes care, based on the perspectives of physicians, to propose strategies for reducing such errors and enhancing patient safety. Methodology: A qualitative research approach was adopted, involving semistructured interviews with 20 physicians at a comprehensive diabetes center in Thiruvananthapuram, Kerala. Participants, with over 20 years of clinical experience in diabetes care, shared their observations on prescription errors. The data were analyzed thematically using R software, and ethical guidelines were followed, including informed consent and confidentiality assurances. Results: Key themes identified include basic prescription practices, where OHAs were frequently prescribed, with insulin often reserved as a last-resort therapy, and GLP-1 analogs rarely prescribed. Prescription legibility issues were common, with illegible handwritten prescriptions lacking critical details. Prescribing issues such as overprescribing, misprescribing, and underprescribing were widely reported. Contraindications were frequently overlooked, with inappropriate prescriptions for patients with renal failure, older adults, and those with liver impairment. Incorrect dosing of insulin and metformin was identified due to inadequate adjustments or cumulative overdosing. Drug–drug interactions, including between GLP-1 analogs and DPP-4 inhibitors, and thiazide diuretics with sodium-glucose transport protein 2 inhibitors, were noted. Transitional prescription errors during care transitions were also highlighted, often linked to poor communication and discrepancies in medication lists. Conclusion: The study highlights critical challenges in diabetes prescription practices and emphasizes the need for personalized care plans, regular medication reviews, and technological integration to reduce errors and improve patient outcomes. Continuous medical education and adherence to evidence-based guidelines are essential for advancing safe and effective diabetes management.