Talay Louis, Vickers Matt, Cheng Tiffany
Faculty of Arts and Social Sciences, University of Sydney, Sydney, NSW 2050, Australia.
Eucalyptus, Sydney, NSW 2000, Australia.
Pharmacy (Basel). 2024 Nov 25;12(6):177. doi: 10.3390/pharmacy12060177.
Pharmacists have often been viewed as the last line of defence against prescription errors in traditional care models. Although a large number of chronic care patients are using telehealth services to increase their access to continuous care, researchers have yet to investigate prescription safety in such settings in Australia. The absence of this literature is particularly concerning in the context of the Australian Government's admission in a 2024 report that the national health system has not adequately addressed the World Health Organization's 'Medication without harm' objective. One of the report's key findings was that knowledge on digital direct-to-consumer services is insufficient. A defining feature of some of these services is their unbundling of the pharmacy component, which logically increases the risk for prescription errors. This study analyzed the frequency of which the Cloud pharmacy network intercepted prescription errors in an unbundled digital sexual dysfunction service for men. Investigators found that Cloud pharmacists were responsible for intercepting 22 (5.31%) the 414 prescribing errors observed in the Pilot Australia service in 2023, including 12 (8.05%) of the 149 prescription errors for premature ejaculation (PE) patients and 10 (3.77%) of the 265 errors for erectile dysfunction (ED) patients. Seven of the errors intercepted by Cloud pharmacists were of high or medium severity, including four drug contraindications, two cases of inadequate patient history reviews, and one case of inadequate counselling. This study also appears to be the first to provide digital prescribing error rate data in an Australian sexual healthcare setting, observing an error rate of 0.86% from 30,649 ED prescriptions, 1.13% from the 13,154 PE prescriptions, and a total prescription error rate of 0.95% (414 out of 43,792 prescriptions). These findings demonstrate the vital role of pharmacists in intercepting prescribing errors in unbundled telehealth services. Possible implications of these findings include the allocation of additional resources across the pharmacy sector and the establishment of regulatory safety standards for unbundled telehealth services.
在传统护理模式中，药剂师常被视为防范处方错误的最后一道防线。尽管大量慢性病患者正在使用远程医疗服务以增加获得持续护理的机会，但在澳大利亚，研究人员尚未对这种情况下的处方安全性进行调查。鉴于澳大利亚政府在2024年的一份报告中承认，国家卫生系统尚未充分实现世界卫生组织的“无害用药”目标，这一领域缺乏相关文献尤其令人担忧。该报告的一项主要发现是，对数字直接面向消费者的服务的了解不足。其中一些服务的一个显著特征是将药房部分进行了拆分，这在逻辑上增加了处方错误的风险。本研究分析了云药房网络在一项针对男性的拆分式数字性功能障碍服务中拦截处方错误的频率。研究人员发现，云药剂师在2023年澳大利亚试点服务中观察到的414例处方错误中，拦截了22例（5.31%），其中包括149例早泄（PE）患者处方错误中的12例（8.05%）以及265例勃起功能障碍（ED）患者处方错误中的10例（3.77%）。云药剂师拦截的错误中有7例为高或中度严重程度，包括4例药物禁忌症、2例患者病史审查不足以及1例咨询不足。本研究似乎也是首个在澳大利亚性健康护理环境中提供数字处方错误率数据的研究，观察到30649例ED处方的错误率为0.86%，13154例PE处方的错误率为1.13%，总处方错误率为0.95%（43792例处方中的414例）。这些发现表明药剂师在拦截拆分式远程医疗服务中的处方错误方面发挥着至关重要的作用。这些发现的可能影响包括在整个药房部门分配额外资源以及为拆分式远程医疗服务制定监管安全标准。
