Assessment of Community Pharmacists' Attitudes and Practices toward Illegible Handwritten Prescriptions in Tripoli, Libya: Contributing Factors and Error Prevention Strategies

Abstract Illegible and poorly handwritten prescriptions (IPHPs) pose a significant risk to patient safety, contributing to medication errors and adverse outcomes. Despite global recognition of this issue, limited data exist on community pharmacists' (CPs) perspectives in Libya. This study aimed to evaluate CPs' attitudes and practices regarding IPHPs, identify factors associated with self-reported dispensing errors, and assess their recommendations for improving prescription safety. A cross-sectional survey was conducted among 273 CPs in Tripoli, Libya, from October to December 2023. A validated Arabic questionnaire assessed pharmacists' demographics, attitudes, practices, and proposed solutions regarding IPHPs. Data were analyzed in SPSS v 26.0 using descriptive statistics (frequencies and percentages). Associations between dispensing errors and key factors were examined with chi-square and Fisher's exact tests (p < 0.05). A majority (55.7%) identified IPHPs as a major cause of dispensing errors, with 27.5% admitting to dispensing errors due to misinterpretation. While 91.6% referred unclear prescriptions back to prescribers, 52.4% dispensed medications despite unresolved ambiguities. High daily prescription volume was significantly associated with self-reported errors (p = 0.035). Pharmacists strongly supported electronic prescriptions (96.3%) as the primary solution, which was significantly associated with error reporting (p = 0.038). High workload (49.8%) and reliance on informal channels such as social media (79.9%) were notable practice patterns. High workload (49.8%) and hesitancy to seek clarification (11%) were notable barriers. This study confirms that illegible prescriptions are a major contributor to dispensing errors in Libyan community pharmacies. High workload and informal verification practices often compromise safety, despite pharmacists' awareness. The overwhelming support for electronic prescriptions indicates a clear, actionable path for improving patient safety and reducing medication errors. Policy reforms and targeted training are essential to improve patient safety in this resource-limited setting.