J Am Pharm Assoc (2003). 2021 Jul-Aug;61(4):e284-e288. doi: 10.1016/j.japh.2020.12.015. Epub 2021 Feb 6.
Pharmacy and medication safety organizations have long recommended that diagnosis or clinical indication be required on medication orders to improve the safety and effectiveness of care.
To assess attitudes of Arizona prescribers and pharmacists toward the inclusion of the clinical indication or the diagnosis on prescription orders and perceived barriers to its implementation in Arizona.
Data were obtained by questionnaires from pharmacists and primary care prescribers after a continuing pharmacy education presentation on the value of including a clinical indication or a diagnosis on prescription orders. The survey was distributed to licensed pharmacists who attended the Arizona Pharmacy Association's Southwest Clinical Pharmacy Seminar. The survey was distributed to primary care providers with active Arizona licenses who attended the Arizona Osteopathic Medical Association Annual Convention and to nurse practitioners after an Arizona Nurse Practitioner Council educational webinar. Prescriber and pharmacist responses were compared using the Mann-Whitney U test. An a priori alpha of 0.05 was used, and in the cases of multiple comparisons, a Bonferroni correction was employed.
A total of 74 complete questionnaires were submitted by prescribers and 54 by pharmacists. Approximately 71% of the prescribers and 66% of the pharmacists agreed that they would support voluntary inclusion of a diagnosis or a clinical indication on prescription orders (P = 0.81). However, the 2 groups disagreed on whether the inclusion of the diagnosis or clinical indication should be a requirement (44% of prescribers agreed vs. 96% of pharmacists, P < 0.001). Two perceived barriers revealed statistically significant differences, with the prescribers being more concerned about possible insurance rejections than pharmacists (P = 0.005, whereas the pharmacists were more concerned about potential software transmission accuracy than prescribers (P < 0.001).
Arizona prescribers and pharmacists in our convenience sample supported the voluntary inclusion of a diagnosis or a clinical indication on prescriptions orders but disagreed as to whether it should be required. Prescribers especially indicated they have a variety of concerns that need to be overcome before they could support a statewide mandate.
长期以来，药房和用药安全组织一直建议在用药医嘱中注明诊断或临床指征，以提高医疗护理的安全性和有效性。
评估亚利桑那州开处方者和药剂师对在处方医嘱中注明临床指征或诊断的态度，以及对在亚利桑那州实施这一规定的潜在障碍的看法。
在为药剂师和初级保健开处方者举办关于在处方医嘱中注明临床指征或诊断价值的继续教育讲座后，通过问卷从他们那里获取数据。这项调查是向参加亚利桑那州药剂师协会西南临床药学研讨会的持照药剂师分发的。调查问卷分发给参加亚利桑那州骨科医师协会年会的有有效亚利桑那州执照的初级保健提供者，以及在亚利桑那州执业护士理事会教育网络研讨会后参加的执业护士。使用 Mann-Whitney U 检验比较开处方者和药剂师的回答。采用预先设定的 alpha 值为 0.05，在多次比较的情况下，采用 Bonferroni 校正。
共提交了 74 份完整的处方者问卷和 54 份药剂师问卷。大约 71%的处方者和 66%的药剂师表示，他们将支持在处方医嘱中自愿注明诊断或临床指征（P=0.81）。然而，这两组在是否应将注明诊断或临床指征作为要求这一点上存在分歧（44%的处方者表示同意，而 96%的药剂师表示同意，P<0.001）。有两个被认为的障碍存在统计学上的显著差异，处方者比药剂师更担心保险拒付（P=0.005），而药剂师比处方者更担心潜在的软件传输准确性问题（P<0.001）。
在我们的便利样本中，亚利桑那州的处方者和药剂师支持在处方医嘱中自愿注明诊断或临床指征，但对是否应将其作为要求存在分歧。处方者特别表示，在他们能够支持全州范围内的强制要求之前，他们有各种各样的顾虑需要克服。
