Abstract

Objective: To evaluate healthcare provider’s (HCPs) knowledge, attitudes, and practices towards managing high-alert medications (HAMs) in the twin cities of Pakistan.
Methodology: This cross-sectional study of 385 randomly selected physicians and pharmacists in Islamabad/Rawalpindi from December 2022 to May 2023 using a validated questionnaire. Data were analyzed using descriptive statistics and chi-square tests to examine associations between demographic variables and KAP questions.
Results: HCPs demonstrated strong knowledge (90.5% recognized HAMs; physicians 99% identified anticoagulants as HAMs vs pharmacists 86%) and positive attitudes (93% supported pharmacist verification). However, significant practice gaps existed: only 26% provided patient counseling, 23% used Institute for Safe Medication Practices safety lists, and 45% encountered HAM-related injuries. Knowledge showed strong associations with age (χ²=256.8, p=0.003), profession (χ²=56.1, p=0.003), and qualification (χ²=12.3, p=0.002). While 79% practiced dose individualization, only 43% received HAM training.
Conclusion: Despite adequate knowledge and safety-conscious attitudes, critical practice deficiencies persist, particularly in patient education and safety protocol implementation. These findings underscore the urgent need for institutional HAM management protocols and competency-based training to enhance medication safety.

Key words: Healthcare providers, high-alert medications, knowledge-attitudes-practices, medication safety, Pakistan.