Incomplete Prescription Research Articles

NARRATIVE REVIEW: INCIDENCE, CAUSES AND INTERVENTION STRATEGIES OF MEDICATION ERRORS TO IMPROVE CHEMOTHERAPY SERVICES IN HOSPITALS

Medication errors (MEs) are medication errors that have the potential to harm patients during treatment or care. Cancer care is a complex and interconnected system and many errors can be catastrophic. ME in antineoplastic drugs have the potential to cause permanent injury and even death. Evaluation measures of ME incidence in Indonesia are still not optimally carried out, thus leading to the need for a good understanding of the potential ME incidence, especially in cancer patient care. A good understanding of the incidence of medication errors will encourage preventive efforts against the potential occurrence of ME. This narrative review aims to provide information related to the incidence of ME in the Chemotherapy department at the hospital, the causative factors, and the handling and prevention efforts. Scientific information searches were conducted on the PubMed and Google Scholar databases for the period 2012-2022. The results showed that the incidence of ME mostly occurred in the prescription phase, namely in the form of dosage errors (45–59.3%), incomplete prescriptions (43–45.5%), drug frequency errors (30.4%), and errors in patient name, age, and diagnosis data (22.5%). Several aspects contributing to the occurrence of ME were identified, including work procedures, staff, organizational systems, and staff understanding of medication regimens. This study concluded that there is a need to regulate and evaluate several aspects, including work procedures, availability of auxiliary systems, and increasing the capacity of human resources involved. This may prevent the occurrence of ME.

How well are we prescribing medications to our children?

Introduction: Prescription errors are common and every step in the process of writing a prescription has the potential for error. These errors can be broadly attributed to the lack of knowledge or lack of skill. Poor legibility, inaccuracy in writing, incomplete prescriptions, omissions, and use of abbreviations are the most common type of errors. Objectives: The primary objective of our study was to assess the completeness and legibility of the prescriptions. This is to estimate the rates of skill-based errors. Secondary objective of this study was to assess the appropriateness of the prescriptions using the pediatrics: Omission of Prescriptions and Inappropriate prescriptions (POPI) tool. Methods: This was a cross-sectional study, conducted in the pediatric outpatient department of a tertiary teaching hospital in New Delhi, India. Prescriptions received by outpatients attending both the general and special pediatric clinics were collected and evaluated using the World Health Organization Guide to Good Prescribing and the Medical Council of India guidelines. Results: A total of 343 prescriptions were assessed, in which 753 drugs were prescribed. A total of 1709 errors were uncovered pertaining to the completeness of the prescription. A majority of the prescriptions were written by postgraduates trainees (206), followed by senior residents (61), consultants (42), and junior residents (20). Abbreviations were used while mentioning the drug names in 53.64% prescriptions. The mean legibility score of all prescriptions was 3.35. Forty (11.66%) prescriptions were found inappropriate as per the International POPI tool. Conclusion: The legibility and completeness are largely overlooked yet crucial to the “Art of Prescription Writing.” They deserve as much awareness and education as the appropriateness of the drugs prescribed. The international POPI tool is a promising tool to analyze the appropriateness of pediatric prescriptions.

Pharmacist Role in Medication Safety in a Busy Public Sector Pediatric Emergency, Pakistan

INTRODUCTION: Medication safety is very crucial part of patient safety as emergency department of any hospital is the busiest place of hospital where the possibility and likelihood of errors are much higher than any other part of the hospital. Human factor inherently limits the safety of health care process and contribute to medication errors. Recently, medication error has justly received significant attention, as it causes mortality, morbidity and additional healthcare costs, for example wrong dose prescribed and wrong dose administered for a prescribed medication.so despite the improved technology in the health care setting errors related to medication use continue to occur. The pharmacist plays a crucial role to oversee the quality of the entire drug distribution chain, from prescribing, drug choice, dispensing and preparation to the administration of drugs, and can fulfil a vital role in improving medication safety. OBJECTIVE: The aim of this study is to find out frequency of different types of prescription error in pediatric emergency to improve mediation as well as patient safety. METHOD: We conducted a retrospective study over a period of 6 months (from January 2023 to June 2023). The data were taken from electronic medical record (EMR) of all patients visiting in one of the pediatric emergency departments supported by child life foundation, who were prescribed intravenous medication were enrolled in the study. These prescriptions were checked by qualified pharmacist for correct dose, route, and timing of the drug. RESULTS: Total of 30,954 patient visited during the study period. 25,931 patients were prescribed intravenous medication. total of 784(3%) prescription errors were picked up. out of which 568 (68%) were due to wrong dose calculation and 76 (10%) patients were prescribed wrong medicine. 63(8%) patient were prescribed wrong units and 46(6%) each for wrong frequency and incomplete prescription. CONCLUSION: Unsafe medication practices leading to medication errors are the main causes of mortality and morbidity that can be prevented by a well trained and a qualified pharmacy department in ED of any hospital. the quality and safety of patient can be improved by preventing common medication error due to heavy flow of patient throughout the day.

Physician experiences with teleconsultations amidst conflict in Sudan

The current conflict in Sudan severely hinders the accessibility of health services across the country. To address this, several initiatives were proposed including offering services using teleconsultations. This study aimed to assess Sudanese doctors' teleconsultation experience, perception, and concerns during the recent conflict. This cross-sectional survey focused on Sudanese medical officers, residents, specialists, and consultants living inside or outside the country having a practice license from the Sudan Medical Council and conducting teleconsultations with Sudanese patients during the conflict period. The questionnaire was distributed to personal and professional contacts and via social media platforms in the English language among doctors who provided teleconsultation during the conflict. Data analysis was performed using the Statistical Package for Social Sciences software version 26. The study enrolled 2463 clinicians from 17 different specialties, and females represented more than half the sample (56.8%). Internal medicine was the most frequent specialty (36.1%) and the majority (68.7%) of clinicians had less than 5 years of work experience. Voice call was the most frequent platform (50.1%) used for teleconsultation during the conflict and had the highest convenience score (p < 0.01), whereas messaging platforms had the lowest score. Most clinicians (73.3%) agreed that teleconsultations created a trusted patient-physician relationship and provided good-quality care (61.8%). However, 85.1% highlighted the importance of physical touch in medical practice. Clinicians were concerned that incomplete information (81.4%), missed diagnosis (76.8%), medicolegal problems (71.0%), and prescription errors (68.4%) could arise with teleconsultations. Most respondents (70.7%) emphasized the importance of continuing to offer teleconsultation even after the war abated. In conclusion, physicians who participated in the current study agreed that teleconsultation provided quality care even in this dire crisis in Sudan. Based on our study findings, we recommend upscaling telemedicine interventions including teleconsultations at the national level. This would require unified coordination efforts of a wide mix of stakeholders to address concerns identified in the current study.

Description the completeness of prescriptions for inpatients at the Pharmacy Installation HKBP Balige General Hospital period of July 2020

Prescription is a written request from a doctor to a pharmacist to provide drugs for patients written in the prescription. For in accordance with applicable laws and regulations to minimize irrational use of drugs and preventmedication errors for patient safety purposes. The purpose of this study was to describe Description the completeness of prescriptions for inpatients at the Pharmacy Installation HKBP Balige General Hospital period of July 2020. The design of this study was descriptive, with a sample of 186 prescriptions, using a cluster random sampling technique. The results showed that 46.2% of prescriptions at the Balige HKBP RSU for the July 2020 period were complete and 53.8% incomplete. Of the total 186 prescription sheets, the information on the doctor's name (27.4%), the doctor's initial (5.9%), the patient's name (0.5%), the patient's address (36.6%), the instructions for use (10,2%). This shows that the completeness of the recipe at RSU HKBP Balige is not complete. Incomplete prescriptions occur because many visiting patients increase the busyness of the prescriber, so doctors do not have time to write a complete prescription. It is recommended to the management of RSU HKBP Balige to put more emphasis on doctors to complete prescriptions, so that TTK does not find incomplete prescriptions anymore.

Assessment of Completeness of Handwritten Prescriptions in Eastern Libya

Background Prescriptions, medicolegal documents issued by physicians to patients, must be written accurately and clearly, contain all the required information, and adhere to the guidelines for prescription writing. In eastern Libya, most prescriptions are handwritten. Incomplete prescriptions might lead to serious medication errors. Aim The aim of this article was to assess the completeness of handwritten prescriptions issued by physicians working in eastern Libya. Method A total of 1,080 handwritten prescriptions were collected from pharmacies in different parts of the city of Derna and its suburbs in eastern Libya. After the exclusion of three prescriptions that were defined as illegible by the researchers, the 1,077 remaining prescriptions were examined for completeness against a checklist designed according to the guidelines of the World Health Organization (WHO). Results Most of the prescriptions (84.12%) did not contain the name of the prescribing physician. The patient's name was not mentioned on 16.06% of the prescriptions. Patient-related information was missing in most of the prescriptions. Most of the physicians (91.27%) prescribed drugs using their trade names. Drug strength, route of drug administration, and duration of therapy were absent in 29.61, 87, and 56.17% of the prescriptions, respectively. Only 26% of the prescriptions contained the date. Conclusion Most of the prescriptions inspected in this study had some deficiencies and did not adhere to the WHO guidelines.

Detection and Prevention of Medication Errors by the Network of Sentinel Pharmacies in a Southern European Region

A medication error (ME) is a drug-related problem that has been recognized as a common and serious threat to patient safety. The aim of this study was to detect and analyze ME reports occurring throughout the therapeutic process through the community's pharmacies in order to improve the efficacy and safety of medications and contribute to the prevention of future MEs. This was a three-year descriptive, observational, and prospective study to detect and analyze the different MEs reported by the Catalan sentinel pharmacies network (Catalan SePhaNet). In total, 1394 notifications of MEs were reported (an incidence rate of 737.34 cases/100,000 inhabitants). MEs were detected more frequently in primary care centers. Most of the MEs reported were caused by an incorrect, incomplete, illegible, or verbal medical prescription (41.3%). Of the global notifications detected, 71.9% did not reach the patient (categories A and B). The drugs most frequently implicated in the reported ME cases were beta-lactam antibiotics. In 6.0% of the cases, the ME caused injury to the patient (categories E and F). In 72.0% of the global notifications, a pharmacist's intervention avoided the ME. The importance of a community pharmacy and the role of a pharmacist were demonstrated in aspects related to patient and drug safety.

Risk management -component part of the quality assurance system of pharmaceutical care

Introduction. In the pharmaceutical field, the quality management is a priority and the risk management is a valuable component of an effective quality system. It involves anticipating hazards and controlling risk through a process of risk awareness, reduction, and review. The aim of this paper was to reveal the usefulness of modern risk management strategies and to assess the impact of risk management in the provision of quality services by community pharmacies. Material and methods. The causes that can lead to medication errors in community pharmacies were identified by applying the CNAM Method combined with the Delphi Technique, later the risks were categorized by the Ishikawa diagram, analyzed and evaluated by applying the expert analysis method (MAE) in risk assessment, graphically represented by the Matrix risks and ranked, highlighting pharmacy activities during which medication errors may occur. Results. The risk factor was calculated for 56 potential risks that can cause medication errors, of which 8 for the activity of ordering medicines, 8 potential risks for the activity of receiving products, 6 risks for the activity of storing products, 17 risks for the preparation of drugs and 17 risks for drug dispensing activity. Applying the MAE method in risk assessment, risk occurrence probability and outcome impact values were obtained for each risk. The potential risks of error were graphically represented using the Risk Matrix. Thus, the following activities with a major level of risk were highlighted, for which urgent measures to minimize the impact are required: illegible writing in prescriptions (15.5), fatigue of pharmaceutical staff (15.48), overwork/ multitasking (14.99), prescriptions containing errors (14.26), insufficient staff knowledge (13.81), ordering inappropriate quantities of products in pharmacies (13.59), incomplete prescriptions (12.86) and similar packaging of medicines (12.63). Conclusions. The results of this paper provide the basis for further research in order to develop a Risk Management Plan in community pharmacy. The causes that can lead to errors in the pharmacy have been identified, by highlighting pharmaceutical activities, during which risks of errors may occur. The work has practical use, and the research results can be applied by pharmacies, contributing to the improvement of their performance.

FIGURE OF POTENTIAL MEDICATION ERROR IN MEDICINE PRESCRIPTION FOR OUTPATIENT SERVICES OF "X" HOSPITAL IN BALI

Background: Medication errors (ME) in health services; in this case, hospitals are supposed to have zero accidents. Evaluation of the potential ME, such as doctor's prescription writing, must still be carried out in an effort to maintain service quality, especially in maintaining patient safety or preventing medication errors. Objective: This research aimed to see the figure of potential medication errors that occur in the prescribing process, in this case, is related to the completeness of the prescription seen from the administration and pharmaceutical approach, as well as the legibility of the prescriptions originating from outpatient services at one of the hospitals in Bali. Methods: This research was observational with a qualitative descriptive approach. Data collection was carried out retrospectively through medication prescriptions for patients received by pharmaceutical installations for outpatient services at hospitals from July until October 2022, totaling 110 prescriptions. Results: Results showed that 1.8% of prescriptions still did not write down the patient's name, then 9.1% of prescriptions had not written down the patient's age, 21.8% of prescriptions had not written down the patient's gender, and as many as 93.6% of prescriptions did not include the patient's weight, 2.7 % of prescriptions did not include the name of the doctor, 75.5% of the prescriptions did not include the doctor's SIP number, 1.8% of the prescriptions still did not write down the rules for using the drug, 10.9% of the prescriptions did not write down the strength of the drug dosage and 19.1% of the prescriptions did not provide information about dosage form to be administered to the patient. This study also shows 8.9% of the prescriptions are Illegible prescription. Conclusion: The results of the research found that administratively and pharmaceutically incomplete prescriptions and also Illegible prescription writing were still found. So the results of this study show how important it is to always evaluate the potential of medication errors, especially at the prescribing and transcribing phases, to improve patient safety.&#x0D; Keywords: Medication error; Prescription; Hospital; Retrospective

A Community and Hospital cAre Bundle to improve the medical treatment of severe cLaudIcation and critical limb iSchaemia (CHABLIS).

Patients with peripheral artery disease (PAD) often do not receive optimal best medical therapy (BMT). Through interaction with patients and healthcare-professionals (HCPs) we developed the LEaflet Gp letter Structured checklist (LEGS) complex clinical intervention to support HCPs in providing guideline-compliant PAD BMT. This was a prospective multicentre study assessing the feasibility and fidelity of delivering the LEGS intervention in primary and secondary care over six months. Intervention fidelity was scored based on the proportion of intervention components used correctly at discharge, 30 days, and six months. Overall, 129 individuals were screened and 120 took part (33% female, 74% with chronic limb threatening ischaemia; 93% recruitment rate). Of those, 118 (98% retention rate) completed follow-up. Mean intervention fidelity score at discharge (primary outcome measure) was 63% [95% Confidence Interval (CI): 39-68%, SD: 5%], exceeding the success criteria set at 60% by a panel of HCPs and patients. This, however, declined to 51% at six months. Eight patients (6.7%) died (all cardiovascular deaths), four (3.3%) had a major lower limb amputation, 12 (10%) had a cardiovascular event, and 13 (11%) were admitted due to limb ischaemia at six months. Incomplete lipid therapy prescriptions and LEGS intervention documents not received by primary care CHPs were the most common reasons for not complying with the LEGS intervention. The LEGS intervention can be delivered in PAD care pathways across different hospitals, primary, and community healthcare settings with acceptable fidelity, to streamline and improve PAD BMT short- and medium-term.

The Introduction of Robotics to an Outpatient Dispensing and Medication Management Process in Saudi Arabia: Retrospective Review of a Pharmacy-led Multidisciplinary Six Sigma Performance Improvement Project.

BackgroundOutpatient pharmacy management aims for improved patient safety, improved quality of service, and cost reduction. The Six Sigma method improves quality by eliminating variability, with the goal of a nearly error-free process. Automation of pharmacy tasks potentially offers greater efficiency and safety.ObjectiveThe goal was to measure the impact that integration of automation made to service, safety and efficiency, staff reallocation and reorientation, and workflow in the outpatient pharmacy department. The Six Sigma problem definition to be resolved was as follows: The current system of outpatient dispensing denies quality to patients in terms of waiting time and contact time with pharmacy professionals, incorporates risks to the patient in terms of mislabeling of medications and the incomplete dispensing of prescriptions, and is potentially wasteful in terms of time and resources.MethodsWe described the process of introducing automation to a large outpatient pharmacy department in a university hospital. The Six Sigma approach was used as it focuses on continuous improvement and also produces a road map that integrates tracking and monitoring into its process. A review of activity in the outpatient department focused on non-value-added (NVA) pharmacist tasks, improving the patient experience and patient safety. Metrics to measure the impact of change were established, and a process map analysis with turnaround times (TATs) for each stage of service was created. Discrete events were selected for correction, improvement, or mitigation. From the review, the team selected key outcome metrics, including storage, picking and delivery dispensing rates, patient and prescription load per day, average packs and lines per prescription, and lines held. Our goal was total automation of stock management. We deployed 2 robotic dispensing units to feed 9 dispensing desks. The automated units were integrated with hospital information technology (HIT) that supports appointments, medication records, and prescriptions.ResultsPostautomation, the total patient time in the department, including the time interacting with the pharmacist for medication education and counseling, dropped from 17.093 to 11.812 digital minutes, with an appreciable increase in patient-pharmacist time. The percentage of incomplete prescriptions dispensed versus orders decreased from 3.0% to 1.83%. The dispensing error rate dropped from 1.00% to 0.24%. Assessed via a “basket” of medications, wastage cost was reduced by 83.9%. During implementation, it was found that NVA tasks that were replaced by automated processes were responsible for an extensive loss of pharmacist time. The productivity ratio postautomation was 1.26.ConclusionsThe Six Sigma methodology allowed for rapid transformation of the medication management process. The risk priority numbers (RPNs) for the “wrong patient-wrong medication error” reduced by a ratio of 5.25:1 and for “patient leaves unit with inadequate counseling” postautomation by 2.5:1. Automation allowed for ring-fencing of patient-pharmacist time. This time needs to be structured for optimal effectiveness.

Evaluation of the legal aspects of prescriptions of drugs subject to prescription retention in a communitarian dispensing pharmacy in Joinville / Avaliação dos aspectos legais da prescrição de medicamentos sujeitos a retenção de receita numa farmácia comunitária de distribuição em Joinville

The prescription is the legal document that defines the patient’s drug therapy, thus it must be intelligible and readable to allow the dispensation of the correct drugs to the patient in the right dose, route of administration and quantity. Incomplete and illegible prescriptions lead to misunderstanding and consequently, medication errors, which may cause from ineffectiveness to serious adverse reactions. Hence, this study aimed to evaluate the legal aspects of drug prescriptions subject to prescription retention in a Basic Health Unit (BHU) of Joinville (Santa Catarina state). For this purpose, the adequacy and legibility of information concerning patients, prescribers, and psychotropic and antimicrobial drugs of the prescriptions dispensed by a BHU from July 15 to August 15, 2018, were analyzed totaling 500 prescriptions, of which 250 were psychotropic and 250 were antimicrobial, about 17% handwritten and 83% typed. No prescriptions mentioned the patients' telephone number and few prescriptions omitted gender and address, especially the handwritten ones. Concerning the prescribers' data, few omissions were observed, related to their contact data. All drugs were prescribed in the Brazilian Common Denomination (BCD), and all psychotropic prescriptions had no omissions of route and quantity, while the handwritten prescriptions of antimicrobials comprised 10-15% omission of these data. Regarding legibility, less than 5% of the prescriptions were partially readable and an even smaller proportion were illegible. Non-standardized abbreviations were observed in 55,6% of the prescriptions. Data allow observing that, although some errors still persist the adoption of typed prescription minimized the problems of legibility, but not the omission of information. The improvement of the prescribing writing applications can also help to minimize omissions and make the prescriptions more comprehensible and ensure adequate guidance on the rational use of medicines.

OBSERVASI PENGKAJIAN KELENGKAPAN RESEP OBAT BATUK SECARA ADMINISTRATIF DAN FARMASETIK PADA PUSKESMAS CILAMAYA DI KABUPATEN KARAWANG

An incomplete prescription has the potential to be one of the causes of medication errors. This incident can be avoided by conducting prescription screening by pharmacists which includes a review of administrative and pharmaceutical aspects. The purpose of this study was to determine the administrative and pharmaceutical completeness of prescriptions for the period January – May 2021 at the Cilamaya Health Center in Karawang Regency. The research method is descriptive quantitative with retrospective data collection. The sampling technique was simple random sampling, and 428 prescription sheets were obtained that met the inclusion criteria. The results showed that the administrative completeness of the prescription consisted of: patient's name 100%, patient age 96%, gender 0%, weight 96%, doctor's name 8%, doctor's initials 43%, prescription date 99%, and room of origin. prescription 76%. Meanwhile, pharmaceutically it consists of: 100% dosage form and strength, 96% drug dosage, 99% drug amount, 100% stability and availability, 96% usage rules and 100% compatibility. It can be concluded that based on Permenkes No. 74 of 2016, prescriptions at the Cilamaya Health Center for the period January – May 2021 are not administratively and pharmaceutically complete.

A nationwide assessment of community pharmacists’ attitudes towards dispensing errors: A cross-sectional study

ObjectivesDispensing errors (DEs) are common causes of preventable harm to patients. Interestingly, very little is known about their prevalence and types in the community pharmacy setting in Lebanon due to the lack of an effective reporting system. Therefore, this study aims to explore the perceptions of community pharmacists about the types of these errors in Lebanon, the factors behind their occurrence, the reasons for underreporting, and the current practices for reducing them. MethodsA cross-sectional survey was conducted through a self-administered questionnaire, using a scale of 0–4, distributed among a sample of community pharmacists in Lebanon. ResultsA total of 171 pharmacists responded to the survey, of whom 68% reported that DEs were common, and 52% believed that they were increasing. The main reported contributing factors to DEs were unreadable and incomplete prescriptions (≈3.0 ± 1.0 out of 5), workload, multitasking, interruptions, similarity in names of medications, and fatigue (≈2.5 ± 1.0). Moreover, the perceived strategies to limit the risks of DEs were collaboration with physicians, improving handwriting, double-checking, proper patient counselling, encouraging reporting, and issuance of guidelines (≈3.2 ± 1.0). Finally, the main reasons for underreporting DEs were the lack of obligation to report and the lack of reporting systems (59% and 56%, respectively). ConclusionsDEs may be very prevalent in Lebanon because they are unmonitored by the authorities. Electronic prescription and fair reporting systems are highly recommended, along with follow-up studies.

Pharmacist responsibility for safe anticoagulant administration

Unclear or incomplete prescription orders can set up pharmacists to err in order processing. Pharmacists may be held liable for malpractice when an order is misinterpreted. A recent case from Illinois serves as an example of such a situation.

Prescription Screening Study for Outpatient Prescribing Administration of Social Security Administrator Patients at Dr R.M Djoelham Regional General Hospital, Binjai City

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;The Impact of errors in prescription incompleteness is diverse, started from those that do not provide any risk at all to the occurrence of disability or even death. The Prescription screening is useful to prevent omissions information, poor prescribing and inappropriate prescribing. The goal of this study was to screen the completeness of administration of outpatient prescriptions for social security administrator patients in regional public hospital Dr. R.M. Djoelham at Binjai City. This is a observational research with a retrospective descriptive design, and use the purposive sampling. This research was conducted at the General Hospital Pharmacy Installation Dr. R.M. Djoelham City of Binjai. This research was conducted from April-June 2021. The population of this study was the number of patient prescriptions from January 2021 to March 2021, namely 3722 prescriptions. The total sample is 98 recipes.The data analysis used is univariate data analysis. The results of the 98 recipes show the percentage of administration of the Inscriptio reached 68.4% and was incomplete reached 31.6%, on complete Invocatio it reached 100%, on Prescriptio the complete reached 95% and the incomplete reached 5%, the Signatura complete reached 91.84% and incomplete reached 8.16%, on Subscriptio the full one reaches 100%, the complete Pro reaches 58.84% and incomplete reached 41.16%. The conclusion of this study is the percentage of complete recipes reached 67.35% while incomplete reached 32.65%.&lt;strong&gt; &lt;/strong&gt;If an incomplete prescription is found, it is hoped that the pharmacy staff will confirm it with the doctor concerned.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keyword: Pharmaceutical Installation, Prescription Completeness, Screening&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;

The extent of community pharmacists' involvement in detecting and resolving Drug Related Problems (DRPs) in prescriptions – A real time study from Sri Lanka

BackgroundAppropriate medication use is necessary to ensure patient safety. Drug Related Problems (DRPs) could result in patient harm. PurposeTo assess the prevalence and types of DRPs in prescriptions, and the proportion of DRPs detected and resolved by community pharmacists during dispensation of prescriptions in a selected community pharmacy. MethodsA prospective, cross-sectional study was conducted in a selected community pharmacy in Colombo, Sri Lanka, where one researcher reviewed for DRPs in systematically selected prescriptions (N = 400), and another directly observed the frequency of DRPs identified by community pharmacists in the same set of prescriptions. Actions taken by pharmacists on resolving DRPs were also documented. DRPs were classified according to a slightly modified version of Pharmaceutical Care Network Euro pe classification V8.01. Descriptive and comparative data analysis were performed using SPSS database V.21. P < 0.05 was considered as significant. ResultsAmong 1986 medications, a total of 1211 DRPs were identified by researchers, of which only 441 DRPs were detected by community pharmacists who participated in the study (N = 24). DRPs identified by the researcher were related to medication selection (N = 15), medication form (N = 1), dose selection (N = 817), duration of treatment (N = 128), incomplete prescriptions (N = 128), and other (outdated prescriptions, missing unit of measurements, and ambiguous names of medications that could not be read by both community pharmacists and researcher) (N = 122) of which only one, one, 394, 13, five, and 27 were identified by pharmacists, respectively. Among 441 DRPs identified by pharmacists, 406 were resolved by them. Most DRPs were self-resolved by pharmacists themselves (367/406), while patients were also sent back to the prescriber (13/406), and some dispensation of medications to patients were refused (9/406). ConclusionAmong the DRPs frequently observed in the sample of community prescriptions, the community pharmacists identified significantly fewer DRPs in relation to each type identified by the researcher, and pharmacists missed some, including incomplete prescriptions, that had potential to harm. Systematic and sustainable training of pharmacists on performing a preliminary prescription review and continuous education programs must be implemented to improve community pharmacist dispensing practices in this community.

Medication Error at the Prescribing Phase

Medication errors are accidental failures in a therapeutic process that lead to and have the potential to cause or harm the patient. Medication errors can endanger patient safety, inconvenience and economic burdens. Medication errors can occur at the prescribing, recording, issuing, and administering stages. Reducing the risk of medication errors is a shared responsibility among patients, healthcare professionals, regulators and the pharmaceutical industry at all levels of healthcare delivery. This research is a quantitative research with a descriptive approach. The population taken was 912 prescriptions written by general practitioners at the PKU Muhammadiyah Cepu Hospital in March-May 2019. The sampling technique used was non-probability sampling, which was total sampling. The instrument used in this study was an observation sheet, then the collected data were processed by editing, coding, scoring, and tabulating stages which were then concluded descriptively. The results showed that the incidence of drug prescribing errors in inpatients at PKU Muhammadiyah Cepu Hospital in March 2019 found that all written prescriptions were 100% administratively incomplete. The incidence of prescription medication errors, especially the doctor's name, was 65.9%, the doctor's practice license number was 100%, the date of the prescription was 48.9%, the sign of R/70.9%, the doctor's initial 48.7% and the patient's address 97.4%. Incomplete administrative prescription writing can result in medication errors that are detrimental to health and add to the economic burden of patients.

Gap analysis of pharmacist communication with community-based oral health care providers

BackgroundCurrent communication techniques among different types of health professionals are often inefficient and ineffective, leading to provider frustration and suboptimal patient care that can have community-wide implications. Oral health care providers (OHCPs) in the United States prescribe high numbers of antibiotics and immediate-release opioids and have practice sites that are physically isolated from those of other health professionals, making communication more challenging. ObjectiveThis study was conducted to identify barriers to effective communication between community pharmacists and OHCPs to inform the processes for improving provider education and the methods for training future pharmacists. MethodsA mixed-methods approach was used. Community pharmacists with an active license were eligible to participate and were recruited via e-mail. The participants received an electronic survey that assessed current communication methods, obstacles to optimal communication, and comparisons of OHCPs with other prescribers. The survey participants were asked to self-identify their interest in telephone interviews, which were analyzed using thematic coding to assess the role of the pharmacist in combating public health issues such as opioid abuse through interprofessional collaboration. ResultsThere were 125 participants (response rate 9%) for the survey and 7 participants for the interviews. The most common reasons for which the pharmacists contacted OHCPs were to address incomplete prescriptions (40%) and medication-related problems (35%), with the most common medication-related problems being adverse drug reactions (35%) or cost issues (25%). The most challenging obstacles to communication included lack of time and lack of professional relationships. The pharmacists’ impressions of OHCPs were largely positive. ConclusionPossible strategies to address the identified communication barriers include creation of a universal communication system and establishment of networks between pharmacists and community providers. This study lays the groundwork for future efforts in the field of interprofessional education research and practice, which can be used to improve delivery of community-based care.

Significance of Medication Reconciliation in Intercepting Admission Medication Errors in the General Medicine Department

The aim of the study was to monitor the discrepancies at admission and during the treatment. A prospective observational study was conducted for a period of 6 mo at a South Indian Tertiary Care Hospital. The study was conducted according to the retrospective model of medication reconciliation. Best possible medication history was collected on interacting with patients, caregivers and medical records. This information was compared with the physician’s prescription at the time of admission. Differences were documented as intentional and unintentional discrepancies. Identified errors were classified based on National Coordinating Council for Medication Error Reporting and Prevention Guidelines. Drug-drug interactions were classified according to their severity. Errors were rectified before reaching the patient. Out of 106 prescriptions, 44 (84.62 %) intentional and 8 (15.38 %) unintentional discrepancies were identified. We have also identified 46 (43.40 %) medication errors, 60 % of medication errors were of incomplete prescriptions and 26 (56.52 %) prescriptions were intervened. We have identified 203 possible drug-drug interactions with an average of 1.92 (±2.71) per prescription. Among them 105 (51.72 %) were major, 90 (44.33 %) were moderate and 8 (11.66 %) were minor. Our study concludes that lack of medication reconciliation leads to medication errors and on the successful implementation of the medication reconciliation, as a tool in detecting and rectifying admission medication errors, we can increase patient safety.