Electronic prescriptions help community pharmacists recognize prescribing errors
Research Activities, October 2009
Electronic order entry (e-prescribing) has been shown to lower the rate of medication errors in hospitals. In the community setting, up to 11 percent of all new prescriptions have at least one problem that requires action on the part of the community pharmacist. E-prescribing can improve patient care and safety in the community as well, suggests a new study. However, as currently implemented at community pharmacies, this still-emerging technology nevertheless poses select threats to both medication safety and effectiveness. Yet this is probably less than handwritten prescriptions, note the study authors.
Pharmacists working at 68 community chain pharmacies in 5 States reviewed 2,690 prescription orders. Intervention was required for 3.8 percent of the e-prescriptions reviewed. Most of these interventions (32 percent) were done to obtain missing information, usually medication instructions. Dosing errors were the second most frequent reason for intervention (18 percent). Prescribers were most often contacted (64 percent) to resolve problems.
In the majority of cases (56 percent), the prescription order was changed and dispensed correctly. Only 10 percent of problem prescriptions were not dispensed, while 12 percent of cases remained unresolved despite the intervention. Each intervention took the community pharmacist an average of 6 minutes to complete at a cost of $4.74 per each problem prescription. This resulted in an incremental personnel cost of $0.18 for the pharmacies. Best practice recommendations are needed to improve e-prescribing, conclude the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS16394).
See "Analysis of community chain pharmacists' interventions on electronic prescriptions," by Terri L. Warholak, Ph.D., B.Pharm, and Michael T. Rupp, Ph.D., B.Pharm, in the January/February 2009 Journal of the American Pharmacists Association 49(1), pp. 59-64.