Prevalence of adverse events due to self-administration errors among patients in a tertiary care hospital: a cross-sectional study utilizing the SAME tool

Background: Self-administration medication errors (SAMEs) are a growing concern in outpatient care, especially among patients with chronic conditions requiring complex medication regimens. Despite perceived competence, many patients may be at risk of medication mismanagement, leading to adverse outcomes. Methods: A cross-sectional study was conducted among 237 patients with chronic diseases. The SAME tool, a 10-item validated instrument (Cronbach’s α=0.814), was used to identify self-administration errors and stratify patients into risk categories. Sociodemographic and clinical data, including pill burden and comorbidities, were analyzed for associations with error prevalence. Results: The prevalence of self-administration medication errors was 31.6%. Forgetting doses (22.4%) was the most frequent error, followed by wrong dose (11.0%) and wrong medication intake (10.1%). Multimorbidity and higher pill burden (≥6 pills/day) were significantly associated with higher error rates (p<0.05), while age and gender showed no significant correlation. Patients were classified as high risk (17.7%), moderate risk (61.2%), and low risk (21.1%) for medication errors. Conclusions: Self-administration medication errors are common, especially among patients with multiple conditions and complex regimens. The SAME tool is effective for identifying at-risk individuals. Targeted interventions focusing on medication literacy and regimen simplification are crucial to enhance adherence and safety in outpatient care.