Sardeli Chrysanthi, Athanasiadis Theodoros, Stamoula Eleni, Kouvelas Dimitrios
Department of Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece.
Healthcare (Basel). 2023 Sep 25;11(19):2619. doi: 10.3390/healthcare11192619.
Pharmacotherapy is an essential part of patient care. In order to achieve optimal health outcomes, safe and effective prescribing and administering of medications is crucial, especially since the process of pharmacotherapy can cause serious problems, mainly adverse events and/or interactions, that often pass undetected.
OBJECTIVE(S): To investigate the feasibility of using community pharmacies as checkpoints to detect errors and failures in prescribing, as well as patients' compliance with pharmacotherapy. To this end, analysis and recording of the prescribing process was carried out and error-prone points were identified.
Patients and caregivers filling prescriptions during the first 4 weeks of November 2017 and February 2018 answered questions in order to evaluate their attendance of regular checkups and their compliance with prescribing instructions. All prescriptions filled at the pharmacy were examined for detection of prescription errors and drug-drug interactions. Statistical analyses, including calculations of the correlation coefficient phi (φ), chi-square, and confidence intervals, were carried out. Detected errors and failures were evaluated by application of the Health Failure Mode Effect Analysis (HFMEA) quality tool.
A significant number of patients (16.7%) failed to regularly attend checkups regarding known health problems (95% CI: 10.6-22.7%), a corresponding percentage (16%, 95% CI: 10.1-21.9%) did not comply with prescribed pharmacotherapy, and a significant proportion of patients self-medicated regularly (32%, 95% CI: 24.5-39.5%). A total of 8.6% of prescriptions included medication combinations with a potential for severe drug-drug interactions (95% CI: 7.1-10.2%) while 58.7% of the prescriptions included combinations that could lead to moderate ones (95% CI: 56.1-61.4). The HFMEA indicated that all problems recorded required immediate interventions, except for prescribing errors.
Community pharmacies can be potential checkpoints for the detection and evaluation of prescribing errors and pharmacotherapy failures.
药物治疗是患者护理的重要组成部分。为了实现最佳健康结果，安全有效地开具和使用药物至关重要，尤其是因为药物治疗过程可能会引发严重问题，主要是不良事件和/或相互作用，而这些问题往往未被察觉。
调查利用社区药房作为检测处方错误和失误以及患者药物治疗依从性的关卡的可行性。为此，对处方过程进行了分析和记录，并确定了易出错点。
2017年11月和2018年2月前4周内取药的患者及护理人员回答问题，以评估他们定期体检的情况和对处方说明的依从性。对药房所有已配药品进行检查，以检测处方错误和药物相互作用。进行了统计分析，包括计算相关系数φ、卡方和置信区间。通过应用健康失效模式效应分析（HFMEA）质量工具对检测到的错误和失误进行评估。
相当数量的患者（16.7%）未能就已知健康问题定期进行体检（95%置信区间：10.6 - 22.7%），相应比例（16%，95%置信区间：10.1 - 21.9%）未遵守规定的药物治疗，且相当一部分患者经常自行用药（32%，95%置信区间：24.5 - 39.5%）。共有8.6%的处方包含有严重药物相互作用可能性的药物组合（95%置信区间：7.1 - 10.2%），而58.7%的处方包含可能导致中度相互作用的组合（95%置信区间：56.1 - 61.4）。HFMEA表明，记录的所有问题除处方错误外均需要立即干预。
社区药房可能成为检测和评估处方错误及药物治疗失误的关卡。
