Burnout, depression, and medication errors among family physicians

Physician burnout has been recognized as a global healthcare threat. Burnout adversely affects doctors' well-being, patient care costs, and quality. The impact of burnout on medication error is debatable since most literature relied on self-reporting, whereas studies utilizing objective measures reported contrary results. Our study investigates physicians' burnout prevalence and association with detected prescribing errors in ambulatory settings. A cross-sectional study was conducted in 25 primary healthcare centers in Alexandria, Egypt. The Professional Fulfillment Index and Patient Health Questionnaire-9 were used to screen for burnout and depression among physicians. Clinical pharmacists independently reviewed 50 prescriptions per physician to identify decision and process prescribing errors. The prescribing errors were assessed by reviewing drug suitability for the patient's condition according to best practice guidelines. Risk variables for prescribing errors were evaluated using multivariable negative binomial analysis. Researchers collected prescriptions from 118 doctors out of 184 who completed the survey. Almost half of the responders suffered from burnout and depression symptoms (42.39% and 42.93%), while most of them reported low personal professional fulfillment (89.13%). Of 14,121 medications evaluated, 6543 prescribing errors were detected (46.34%), with only 0.11% of them potentially serious. The most prevalent prescribing error types were wrong dosage regimens, incomplete patient information, and missing drug instructions. Analgesics, systemic antihistaminics, and antibacterials were the most misprescribed ATC drug categories. Prescribing errors had no significant association with burnout, professional fulfillment, depression, or thoughts of quitting among doctors. Males, consultants, and rural work settings physicians were more prone to commit ordering errors. Prescribing errors were prevalent in primary care settings, but they were not significantly linked to physicians' burnout, professional fulfillment, or depression. The burden of burnout and depression among physicians, as well as the complexity of evaluating their impact on actual patient safety, highlights the need for further research and tailored interventions.