Background In Belgium, all hospitals are required to take safety measures with high risk medications. We focused on look-alike (LA) injectable drugs in our 1124 bed general hospital.

Purpose The main purpose of this study was identifying LA drugs in our formulary. The secondary purpose was to determine whether the same firm or volume is a contributing factor.

Material and methods All injectable drugs in our formulary were selected and categorised based on their shape (table 1). Their characteristics were assessed (volume, firm, high risk and use).

19 healthcare practitioners (doctor, pharmacist, nurse and technician) assessed pairs that looked alike. When ≥18 agreed, the pair was said to be at a ‘very high risk of confusion’ (VHRC), and when 13–17 agreed, the pair was said to be at ‘high risk of confusion’ (HRC).

Results Out of 11 544 possible pairs, only 329 (2.85%) were recognised as being LA by one of the practitioners. 9 pairs were at VHRC and 19 were at HRC.

Drugs from the same firm and that had the same volume had a higher risk, weight and gravity. Same firm seemed to be the most important contributing factor to high risk and weight.

Conclusion LA drugs are an important issue in our practice. Identification of LA drugs in our hospital allowed us to inform practitioners. Safety measures can be implemented in hospitals but this analysis shows that pharmaceutical firms should also address the issue when developing packaging for drugs.

No conflict of interest.