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Prescribing errors and other problems reported by community pharmacists

Authors Yen-Fu Chen, Karen E Neil, Anthony J Avery, Michael E Dewey, Christine Johnson

Published 15 December 2005 Volume 2005:1(4) Pages 333—342

Yen-Fu Chen1, Karen E Neil2, Anthony J Avery3, Michael E Dewey4, Christine Johnson5

1Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK; 2Pharmacist, Nottingham, UK; 3Division of Primary Care, University of Nottingham, Nottingham, UK; 4Institute of Psychiatry, King’s College London, London, UK; 5Nottingham Primary Care Research Partnership, Nottingham, UK

Introduction: Prevention of medication errors is a priority for health services worldwide. Pharmacists routinely screen prescriptions for potential problems, including prescribing errors. This study describes prescribing problems reported by community pharmacists and discusses them from an error prevention perspective.

Method: For one month, nine community pharmacists documented prescribing problems, interventions made, and the proximal causes of the problems. The results were presented to local GPs and pharmacists at a meeting and feedback was invited.

Results: For 32 403 items dispensed, pharmacists reported 196 prescribing problems (0.6%). The reporting rates ranged from 0.2%–1.9% between pharmacists and were inversely correlated to dispensing volume. Prescriptions containing incomplete or incorrect information accounted for two-thirds of the problems. Lack of information on the prescriptions and transcribing/typing errors were the most frequently cited proximal causes. A few pitfalls of computerized prescribing were observed.

Conclusion: Although rates of prescribing problems reported were relatively low, community pharmacists and patients remain important safeguards. This study identified potential causes of prescribing errors, and illustrated areas which could be improved in the design of computerized prescribing systems, and the communication and sharing of information between GPs and pharmacists.

Keywords: prescribing errors, general practice, community pharmacy

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