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过渡到电子处方:预格式化处方表单可提高安全性、配方遵从性、处方满意度和感知效率。

Transitioning to E-Prescribing: Preformatted Prescription Forms Improve Safety, Formulary Compliance, Prescribing Satisfaction, and Perceived Efficiency.

机构信息

Infectious Disease, and.

Internal Medicine, Olive View-UCLA Medical Center, Sylmar, CA.

出版信息

J Patient Saf. 2018 Dec;14(4):241-245. doi: 10.1097/PTS.0000000000000198.

Abstract

OBJECTIVES

Compared with blank prescriptions, electronic prescribing (e-prescribing) is safer and more formulary-compliant, satisfying, and efficient. Owing to cost, fewer publicly funded organizations use e-prescribing but may afford preformatted prescription forms. We investigated whether preformatted prescription forms confer similar benefits as e-prescribing.

METHODS

Two preformatted prescription forms containing medications' name, strength, dose, route, frequency, number of refills, and restrictions were released in an adult medicine clinic, which previously used blank forms. Pharmacy data were evaluated for changes in prescribing safety and formulary compliance. Surveys assessed changes in prescribing satisfaction and perceived efficiency.

RESULTS

Preformatted prescription forms yielded safer, more formulary-compliant prescribing than blank forms. Among medications preformatted on forms, a smaller percentage of pharmacy interventions were for prescribing errors compared with the same medications prescribed previously using blank forms (54% vs. 31%, P = 0.014). Among medications preformatted on forms, a smaller percentage of pharmacy interventions were for formulary noncompliance compared with the same medications prescribed previously using blank forms (21% vs. 4%, P = 0.002).Nearly all respondents felt preformatted forms helped with legibility and choosing the correct dose and proper strength. Fifty percent of respondents indicated the forms improved medication selection.Preformatted forms were perceived as more satisfying and efficient. Ninety-three percent of respondents stated they would use the forms on their next patient.

CONCLUSIONS

Preformatted prescription forms achieved the major objectives of e-prescribing: safer, more formulary-compliant, satisfying, and efficient prescribing. They can serve as a transitional phase to e-prescribing for resource-constrained organizations such as publicly funded clinics.

摘要

目的

与空白处方相比,电子处方(e-prescribing)更安全、更符合处方集规定,也更令人满意、更高效。由于成本原因,使用电子处方的公共资助组织较少,但可能会提供预格式化处方表格。我们研究了预格式化处方表格是否能带来与电子处方类似的好处。

方法

在一个成人内科诊所,发布了两种包含药物名称、强度、剂量、途径、频率、续方次数和限制的预格式化处方表格,此前该诊所使用空白表格。对处方的安全性和符合处方集的情况进行了评估。通过调查评估了处方满意度和感知效率的变化。

结果

预格式化处方表格比空白表格的处方更安全、更符合处方集规定。与使用空白表格之前开具的相同药物相比,在使用表格预格式化的药物中,因处方错误而需要药房干预的比例较小(54%比 31%,P = 0.014)。与使用空白表格之前开具的相同药物相比,在使用表格预格式化的药物中,因不符合处方集规定而需要药房干预的比例较小(21%比 4%,P = 0.002)。几乎所有受访者都认为预格式化表格有助于提高清晰度,并帮助选择正确的剂量和适当的强度。50%的受访者表示表格改善了药物选择。预格式化表格被认为更令人满意和高效。93%的受访者表示他们会在下次为患者开处方时使用这些表格。

结论

预格式化处方表格实现了电子处方的主要目标:更安全、更符合处方集规定、更令人满意和高效的处方。对于资源有限的组织(如公共资助的诊所),它们可以作为电子处方的过渡阶段。

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