Appropriateness of ambulatory prescriptions in Taiwan: translating claims data into initiatives

Ho, Yunn‐Fang; Hsieh, Ling‐Ling; Lu, Wan-Chen; Hu, Fu‐Chang; Hale, Kenneth M.; Lee, Shu-Jen; Lin, Fang‐Ju

doi:10.1007/s11096-011-9589-8

Cited by 6 publications

(7 citation statements)

References 32 publications

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“…Many medication errors may be the result of cognitive errors in medical decision making, or skills‐based errors, or performance and knowledge deficits . The most commonly reported medication errors centred on miscalculated and mistaken doses, or missteps . Fifty‐three percent of the drug errors found by Kuo et al consisted of prescribing errors.…”

Section: Discussionmentioning

confidence: 99%

“…Fifty‐three percent of the drug errors found by Kuo et al consisted of prescribing errors. In Ho et al's research, “prescribing errors included errors of omission (25.5%), errors of commission (53.4%), and others (21.1%),” with the top three errors cited as “incorrect dosage (27.5%), missing indication (23.6%), and insufficient or unavailable drug information (18.9%).” Some medication errors were caused by ineffective handovers rather than errors in communication itself. Benjamin et al provided an explicit description of defective handovers caused by inaccurate or incomplete information, ineffective handover methods, lack of standardised procedures for handovers, and uninformed referrers lacking knowledge about their patients.…”

Section: Discussionmentioning

confidence: 99%

“…Many medication errors may be the result of cognitive errors in medical decision making, or skills-based errors, or performance and knowledge deficits. [32][33][34] The most commonly reported medication errors centred on miscalculated and mistaken doses, or missteps. 18,27,32,33,[35][36][37][38][39][40] Fifty-three percent of the drug errors The highest reported rate of communication errors was described as part of a cascade event analysis of anonymous error reports by Woolf et al 24 In an effort to identify various stages of mistakes and link chains of errors together, they found that 67% of errors reported by a group of family physicians could be attributed…”

Section: Discussionmentioning

confidence: 99%

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Debunking the myth that the majority of medical errors are attributed to communication

Clapper

Ching

2019

Medical Education

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Context Many articles, book chapters and presentations begin with a declaration that the majority of medical errors are attributed to communication. However, this statement may not be supported by the research reported in the literature. Objectives The purpose of this systematic review is to identify where errors are reported in the research literature. Methods A systematised review was conducted of research articles over the last 20 years (1998‐2018) indexed in PubMed/MEDLINE and the Cumulative Index to Nursing and Allied Health (CINAHL) using term combinations: medical errors, research and communication. Inclusion was based on reported generalised primary research of medical error and the reported causes. Results This systematised review resulted in 2881 research articles, which produced 42 that met the inclusion criteria. Although there was some overlap, three categories of errors were dominant in this research: errors of commission (20 articles; 47.6%), errors of omission (six articles; 14.2%) and errors through communication (four articles; 9.5%). There were 12 (28.5%) articles in which all three categories together significantly contributed to error. Of these 12 articles, errors of commission or omission were dominant in nine articles (21.4%) and errors of communication were prevalent in only three articles (7%). Conclusions The assertion that the majority of medical errors can be attributed to miscommunication is not supported by this systematic review. Overwhelmingly, most reported errors are attributed to errors of omission or commission. Intentionally or unintentionally providing misinformation may mislead patient safety initiatives, and research and funding agency priorities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Debunking the myth that the majority of medical errors are attributed to communication

Clapper

Ching

2019

Medical Education

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“…In a Taiwan-based study, identified prescription errors in 18.3% (n = 560) of prescriptions at the community setting; potential prescribing errors included errors of omission (25.5%), errors of commission (53.4%), and others (21.1%). The top three errors were incorrect do-sage (27.5%), missing indication (23.6%), and insufficient or unavailable drug information (18.9%) (Ho et al, 2012). Similarly, pharmacist´s intervention is comparable.…”

Section: Discussionmentioning

confidence: 99%

Nature and frequency of prescription modifications: An evaluation from the community pharmacy

Sánchez¹

2014

Afr. J. Pharm. Pharmacol.

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Medication errors can occur at any point in the medication use process. The present study was undertaken to investigate the frequency and nature of prescription modifications and pharmacist's interventions outcomes at the community pharmacy. A descriptive and prospective study was conducted and data were structured by all prescriptions that were modified by the pharmacy during the study. All medicines were classified into therapeutic groups using the Anatomical Therapeutic Chemical classification. A total of 20,205 prescriptions were processed during the study and the overall incidence of modifications by the community pharmacy was 10.9 % (2216 prescriptions). The majority (1676; 75.6%) of the reasons for the medications concerned the clarification of an insufficiently specified prescription. Drug-drug interaction (32.5%), contraindication (6.5%) or double medications (40.6%) were prevalent. The findings of this study reinforce the importance of prescription screening and interventions by pharmacists in reduce preventable adverse events attributed to medication errors. It also emphasizes the necessity of interdisciplinary communication and cooperation in identifying and resolving prescribing errors and irregularities in order to achieve optimal therapeutic outcomes for the patient.

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“…Using such prescriptions, patients can refill their prescription at insurance-contracted community pharmacies of their choice without revisiting a doctor’s office [ 21 ]. Community pharmacies contracted with NHI have the following key characteristics: (i) they are financially independent from any hospitals or clinics, but may collaborate with primary-care physicians; [ 22 ] and (ii) they can sell over-the-counter drugs, and dispense prescription drugs for patients presenting prescriptions from any hospitals or clinics (including chronic medication prescriptions) and be reimbursed by NHI (in contrast, hospital pharmacies can only dispense prescriptions from their related hospitals or clinics) [ 23 ]. The objectives of the promotion strategies for chronic medication prescriptions are to reduce unnecessary outpatient services and related expenses, including outpatient registration fees, medication copayments, and traveling expenses, and to enhance more convenient access to medicines for treatment of chronic disease for clinically stable patients.…”

Section: Introductionmentioning

confidence: 99%

Utilization of oral antidiabetic medications in Taiwan following strategies to promote access to medicines for chronic diseases in community pharmacies

Hsu

Ross‐Degnan

Wagner

et al. 2015

J of Pharm Policy and Pract

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ObjectivesTaiwan’s National Health Insurance (NHI) has encouraged physicians to use “chronic medication prescriptions” for patients with stable chronic diseases since 1995. Patients are allowed to refill such prescriptions at community pharmacies for a maximum of three months’ supply of medications without revisiting the doctor. In 2006, NHI initiated strategies targeting the public, doctors, and healthcare facilities to enhance the overall rate of chronic medication prescriptions, aiming to achieve 30% by 2010. We examined prescribing and dispensing of oral antidiabetic drugs from 2001 to 2010, before and after the start of the promotion strategies for chronic medication prescriptions in 2006.MethodsUsing outpatient care data from the NHI database and the interrupted time series design, we analyzed changes in rate of chronic medication prescriptions, share of prescriptions filled at community pharmacies, and share of reimbursed expenditures accounted by community pharmacies.ResultsDuring 2001-2010, the rate of chronic medication prescriptions for diabetes increased steadily by about 3% per year (from 3.5% to 26.2%). Three years after the promotion strategies, there was a non-significant reduction of 8.7% (95% confidence interval [CI]: -17.35%, 0.05%) in the rate of chronic medication prescriptions but increases in prescription refills at community pharmacies and associated reimbursed expenditures: 12.8% (95% C.I.:1.66%, 23.98%) and 15.8% (95% C.I.: -1.35%, 33.02%) respectively.ConclusionsWhile rate of chronic medication prescriptions was not significantly affected by the 2006 promotion strategy, shares of prescriptions refilled at community pharmacies and associated expenditures increased slightly but significantly.

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Appropriateness of ambulatory prescriptions in Taiwan: translating claims data into initiatives

Cited by 6 publications

References 32 publications

Debunking the myth that the majority of medical errors are attributed to communication

Debunking the myth that the majority of medical errors are attributed to communication

Nature and frequency of prescription modifications: An evaluation from the community pharmacy

Utilization of oral antidiabetic medications in Taiwan following strategies to promote access to medicines for chronic diseases in community pharmacies

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