Rupp M T, DeYoung M, Schondelmeyer S W
Department of Pharmacy Practice, School of Pharmacy and Pharmacal Sciences, Purdue University, West Lafayette, IN 47907.
Med Care. 1992 Oct;30(10):926-40. doi: 10.1097/00005650-199210000-00005.
Interventions performed by 89 community pharmacists in 5 states to correct the prescribing problems they identified on new prescription orders were documented by trained observers. Pharmacists intervened to resolve a prescribing-related problem in 623 (1.9%) of 33,011 new prescription orders that were screened and dispensed during the study period. A panel of three expert evaluators concluded that 28.3% of the prescribing problems identified during the study could have caused patient harm if the pharmacist had not intervened to correct the problem. The rate at which pharmacists identified prescribing problems was negatively related to the number of prescriptions they dispensed per hour, suggesting that in pursuing distributive efficiency, some pharmacists may be exceeding their safe dispensing threshold. The authors recommend that the interprofessional system of oversight and verification (i.e., "checks and balances") in the delivery of pharmaceutical care in the community setting should be maintained and strengthened.
在5个州的89名社区药剂师对他们在新处方订单上发现的处方问题进行干预的情况，由经过培训的观察员进行了记录。在研究期间筛选并配发的33011份新处方订单中，药剂师对623份（1.9%）订单进行了干预以解决与处方相关的问题。一个由三名专家评估员组成的小组得出结论，如果药剂师没有进行干预来纠正问题，那么在研究期间发现的28.3%的处方问题可能会对患者造成伤害。药剂师发现处方问题的比率与他们每小时配发的处方数量呈负相关，这表明在追求配药效率时，一些药剂师可能超过了他们安全配药的阈值。作者建议，在社区环境中提供药学服务时，应维持并加强跨专业的监督和核查系统（即“制衡机制”）。
