Effect of Patient Information on the Quality of Pharmacists’ Drug Use Review Decisions

Warholak-Juarez, Terri; Rupp, Michael T.; Salazar, Theresa A.; Foster, Stephan L.

doi:10.1016/s1086-5802(15)30396-x

Cited by 20 publications

(17 citation statements)

References 8 publications

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“…Pharmacists also reported in a previous study that being provided the indication on prescriptions helped reduce consultation time with the prescriber in order to clarify or correct prescriptions from 38.7% ( n = 22/57) to 61.5% ( n = 8/13); hence decreasing interruptions for prescribers [ 19 ]. Previous research have found that pharmacists make better clinical decisions if they know the diagnosis or reason for prescribing [ 21 ]. This holds true for electronic prescriptions as well [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Warholak-Juarez et al studied how additional patient information given to a pharmacist would affect their clinical decision making [ 21 ] and found that pharmacists were able to make better clinical decisions when they had more patient information available to them, such as the diagnosis/problem (i.e. purpose of the medication) [ 21 ]. The less information pharmacists had about the patient, the more they realized the assumptions they were making [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…The less information pharmacists had about the patient, the more they realized the assumptions they were making [ 21 ]. Compared to having complete patient information to incomplete information, pharmacists in the study by Warholak-Juarez et al were able to realize the risk they could have put a patient in when making clinical decisions without complete patient information [ 21 ]. This further supports the positive effect of having the indication documented on a prescription.…”

Section: Discussionmentioning

confidence: 99%

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What do Australian consumers, pharmacists and prescribers think about documenting indications on prescriptions and dispensed medicines labels?: A qualitative study

Garada

McLachlan

Schiff

et al. 2017

BMC Health Serv Res

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BackgroundDocumenting the indication on prescriptions and dispensed medicines labels is not standard practice in Australia. However, previous studies that have focused on the content and design of dispensed medicines labels, have suggested including the indication as a safety measure. The aim of this study was to investigate the perspectives of Australian consumers, pharmacists and prescribers on documenting the indication on prescriptions and dispensed medicines labels.MethodsSemi-structured interviews were conducted and mock-up of dispensed medicines labels were designed for participants. Consumers (n = 19) and pharmacists (n = 7) were recruited by convenience sample at community pharmacies in Sydney (Australia) and prescribers (n = 8), including two medical students, were recruited through snowballing.ResultsThirty-four participants were interviewed. Most participants agreed that documenting the indication would be beneficial especially for patients who are forgetful or take multiple medications. Participants also believed it would improve consumers’ medication understanding and adherence. Prescribers and pharmacists believed it could help reduce prescribing and dispensing errors by matching the drug/dosage to the correct indication. Prescribers refrained from documenting the indication to protect patients’ privacy; however, most patients did not consider documenting the indication as a breach of privacy. Prescribers raised concerns about the extra time to include indications on prescriptions and best language to document indications, using plain language as opposed to medical terminology.ConclusionsAll interviewed stakeholders identified numerous benefits of documenting the indication on prescriptions and dispensed medicines labels. Whether these potential benefits can be realized remains unknown and addressing prescribers’ concern regarding the time involved in documenting the indication on prescriptions remains a challenge for vendors of electronic medication management systems.Electronic supplementary materialThe online version of this article (10.1186/s12913-017-2704-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

What do Australian consumers, pharmacists and prescribers think about documenting indications on prescriptions and dispensed medicines labels?: A qualitative study

Garada

McLachlan

Schiff

et al. 2017

BMC Health Serv Res

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show abstract

“…Warholak et al . showed that pharmacists were able to give better pharmaceutical support when they had a more complete overview of a patient's medical record . Furthermore, a review on clinical decision support noted that drug‐disease interaction alerts could only work if the diagnoses and conditions of a patient, even as the degree of impairment have been accurately entered into the medical or pharmaceutical record of a patient .…”

Section: Discussionmentioning

confidence: 99%

Medication safety in patients with hepatic impairment: A survey of community pharmacists' knowledge level and their practice in caring for these patients

Weersink

Abadier

Boer

et al. 2020

Brit J Clinical Pharma

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Aims To study community pharmacists' level of knowledge on medication safety in patients with hepatic impairment and their practice in caring for these patients. Methods Pharmacists from Dutch community pharmacies (n = 1545) were invited to participate in an online survey. The survey consisted of 27 questions covering 2 main topics: knowledge and current practice. The level of knowledge was measured by a 6‐item knowledge test. Multiple linear regression was used to identify predictors of correctly answered responses. Results In total, 338 pharmacists (22%) completed the questionnaire. The mean knowledge score was 2.8 (standard deviation 1.6). Only 30.3% of respondents were able to appropriately advise on use of analgesics in severe cirrhosis. Postgraduate education on hepatic impairment, knowledge of recently developed practical guidance, and fewer years of practice were associated with a higher level of knowledge. In total, 70.4% indicated to evaluate medication safety in a patient with hepatic impairment at least once weekly. In the past 6 months, 83.3% of respondents consulted a prescriber about a patient with hepatic impairment. Frequently encountered barriers in practice were insufficient knowledge on the topic and a lack of essential patient information (i.e. diagnosis and severity of the impairment). Conclusion Community pharmacists regularly evaluate the safety of medication in patients with hepatic impairment, yet their level of knowledge was insufficient and additional education is needed. Pharmacists experienced several difficulties in providing pharmaceutical care. If these issues are resolved, pharmacists can play a more active role in ensuring medication safety in their patients with hepatic impairment.

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“…Some studies have shown that errors can be identified using the Indian Health Service counselling method of opening the bottle and using teach back techniques 28. Other studies have identified that adding additional patient information helps pharmacists to identify medication errors 29. This trend has continued as more authors have identified a need to provide pharmacists with additional patient information such as diagnosis or reason for use to prevent medication errors 30–33.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of community pharmacy error rates in the USA: 1993–2015

et al. 2018

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ImportanceWhile much is known about hospital pharmacy error rates in the USA, comparatively little is known about community pharmacy dispensing error rates.ObjectiveThe aim of this study was to determine the rate of community pharmacy dispensing errors in the USA.MethodsEnglish language, peer-reviewed observational and interventional studies that reported community pharmacy dispensing error rates in the USA from January 1993 to December 2015 were identified in 10 bibliographic databases and topic-relevant grey literature. Studies with a denominator reflecting the total number of prescriptions in the sample were necessary for inclusion in the meta-analysis. A random effects meta-analysis was conducted to estimate an aggregate community pharmacy dispensing error rate. Heterogeneity was assessed using the I2 statistic prior to analysis.ResultsThe search yielded a total of 8490 records, of which 11 articles were included in the systematic review. Two articles did not have adequate data components to be included in the meta-analysis. Dispensing error rates ranged from 0.00003% (43/1 420 091) to 55% (55/100). The meta-analysis included 1 461 128 prescriptions. The overall community pharmacy dispensing error rate was estimated to be 0.015 (95% CI 0.014 to 0.018); however, significant heterogeneity was observed across studies (I2=99.6). Stratification by study error identification methodology was found to have a significant impact on dispensing error rate (p<0.001).Conclusion and relevanceThere are few published articles that describe community pharmacy dispensing error rates in the USA. Thus, there is limited information about the current rate of community pharmacy dispensing errors. A robust investigation is needed to assess dispensing error rates in the USA to assess the nature and magnitude of the problem and establish prevention strategies.

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Effect of Patient Information on the Quality of Pharmacists’ Drug Use Review Decisions

Cited by 20 publications

References 8 publications

What do Australian consumers, pharmacists and prescribers think about documenting indications on prescriptions and dispensed medicines labels?: A qualitative study

What do Australian consumers, pharmacists and prescribers think about documenting indications on prescriptions and dispensed medicines labels?: A qualitative study

Medication safety in patients with hepatic impairment: A survey of community pharmacists' knowledge level and their practice in caring for these patients

Systematic review and meta-analysis of community pharmacy error rates in the USA: 1993–2015

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