Hooper Richard, Adam Abdullah, Kheir Nadir
Medical Services Department.
Drug Healthc Patient Saf. 2009;1:73-80. doi: 10.2147/dhps.s5534. Epub 2009 Nov 30.
To characterize prescribing error interventions documented by pharmacists in four pharmacies in a primary health care service in Qatar.
The study was conducted in a primary health care service in the State of Qatar in the period from January to March 2008. Pharmacists in four clinics within the service used online, integrated health care software to document all clinical interventions made. Documented information included: patient's age and gender, drug therapy details, the intervention's details, its category, and its outcome. Interventions were categorized according to the Pharmaceutical Care Network Europe Classification of drug-related problems (DRP).
The number of patients who had their prescriptions intercepted were 589 (0.71% of the total 82,800 prescriptions received). The intercepted prescriptions generated 890 DRP-related interventions (an average of 1.9% DRPs identified across the four clinics). Fifty-four percent of all interventions were classified as drug choice problems, and 42% had safety problems (dose too high, potential significant interaction). The prescriber accepted the intervention in 53% of all interventions, and the treatment was changed accordingly. Interventions as a result of transcription errors, legality and formulary issues were eliminated from this study through the use of computerized physician order entry (CPOE).
Documenting and analyzing interventions should be a routine activity in pharmacy practice setting in primary health care services. Educational outreach visits and other strategies can improve prescribing practices and enhance patient safety.
对卡塔尔一家初级卫生保健服务机构中四家药房的药剂师记录的处方错误干预措施进行特征描述。
该研究于2008年1月至3月在卡塔尔国的一家初级卫生保健服务机构开展。该服务机构内四家诊所的药剂师使用在线综合医疗软件记录所有实施的临床干预措施。记录的信息包括:患者的年龄和性别、药物治疗细节、干预措施细节、类别及其结果。干预措施根据欧洲药物治疗护理网络药物相关问题分类(DRP)进行分类。
处方被拦截的患者有589名(占总共收到的82800张处方的0.71%)。被拦截的处方产生了890项与DRP相关的干预措施(四家诊所平均识别出1.9%的DRP)。所有干预措施中有54%被归类为药物选择问题,42%存在安全问题(剂量过高、潜在重大相互作用)。在所有干预措施中,53%的干预措施处方医生接受了,治疗也相应改变。通过使用计算机化医嘱录入(CPOE),本研究排除了因转录错误、合法性和处方集问题导致的干预措施。
记录和分析干预措施应成为初级卫生保健服务药房实践中的常规活动。开展教育外展访问和其他策略可以改善处方行为并提高患者安全性。