Minimising Prescribing Errors: A Phenomenological Exploration of the Views and Experiences of Independent Prescribing Pharmacists.

Abstract

This study aims to explore the views and experiences of pharmacist independent prescribing (IPs) regarding prescribing errors and strategies to mitigate errors in practice. One-to-one online semi-structured interviews were conducted with IP pharmacists across the UK. Verbatim transcripts of the interview were generated and coded using NVivo® 12 software for thematic analysis. A mixed inductive and deductive approach was used to generate themes and sub-themes which were then mapped onto the framework of factors that influence clinical practice proposed by Vincent et. al. A total of 14 interviews were conducted. Participants linked the risk-averse nature of a pharmacist, self-perception of their roles as medicines experts, and previous experience of keeping checks on doctor's prescriptions as a dispenser often made them feel confident in prescribing. However, lacking adequate diagnostic skills, inadequate prescribing training programmes, and dealing with complex patients often made them feel vulnerable to committing errors. Organisational and system-related factors such as work interruptions and increased workload were identified as other factors linked to prescribing errors. Independent prescribing pharmacists use a variety of strategies to reduce the risk of prescribing errors. Promoting diagnostic competency in their area of practice, strengthening undergraduate and prescribing curricula, and addressing known organisational and system-related factors linked to prescribing errors can minimise errors and promote patient safety.