Role of pharmacists in reducing antibiotic prescribing errors in an emergency department

Abstract

Background Clinical pharmacists and clinically trained pharmacists can detect and correct prescribing errors by reviewing physicians' orders. In addition, prescribing errors related to antibiotics occur frequently in emergency departments (EDs). Aim This study evaluated the role of pharmacists in reducing antibiotic prescribing errors in an ED. Methods One clinically trained pharmacist spent 4 h/day in the ED for 30 days. The pharmacist attended the ward rounds and reviewed medical records to identify prescribing errors related to antibiotics, and corrected these errors in consultation with emergency physicians. The types and severity of antibiotic prescribing errors were determined. The corrected errors were also classified. Results Antibiotics had been prescribed for 110 of 267 patients (41.20%). In all, 180 antibiotic prescriptions were identified for 57 patients, of which 78 had prescribing errors. The most common types of errors were incorrect drug selection (48/78; 61.50%) and wrong dose (19/78; 24.40%), and the most common actual severities were Type B (30/78; 38.46%) and Type C (35/78; (44.87%). In addition, 41 of 78 antibiotic prescribing errors were accepted as errors by emergency physicians. The corrected prescribing errors were categorised as two (4.88%) intercepted potential adverse drug events (ADEs), 35 (85.36%) mitigated ADEs and four (9.76%) ameliorated ADEs. Conclusion Pharmacists have a significant role in the identification and correction of antibiotic prescribing errors. In addition, collaboration between physicians and pharmacists can lead to more appropriate antibiotic use in hospitals.

Evaluation of Antibiotic Use in Kazakhstan for the Period 2017–2019 Based on WHO Access, Watch and Reserve Classification (AWaRe 2019)

“…), the functions of clinical pharmacologists for the rational use of medicines are successfully performed by clinical pharmacists, whose main responsibilities are to check prescriptions and advise medical staff and patients on the use of drugs [ 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Clinical pharmacists and general pharmacists can detect and correct errors in prescriptions by reviewing medical prescriptions and reduce costs associated with misuse, errors and avoidable adverse events [ 20 , 21 ]. In addition, the implementation at the local level of the practice of analyzing the consumption of antibiotics will allow a comparison of the absolute consumption of antibiotics in the context of a particular medical organization for previous years, and then, using data on absolute consumption, make a relative comparison in accordance with the AWaRe categories.…”

Antibiotic Prescribing Pattern; Errors Perspective in Primary Health Care Centers in Riyadh City, Saudi Arabia

“…[25][26][27][28] The prevalence of errors in antibiotic prescribing was lower than previously in some studies, which has been related to the number of prescribing medications being low or different settings like hospitals or emergency departments setting which had a higher prevalence of medication errors or the antibiotic policy was poorly implemented. 19,[25][26][27][28]30 In contrast, the percentage of errors was higher than in one study that used electronic prescribing. 29 The study showed that most of the prescribing was for females, related to primary healthcare visiting, which is most suitable for females to visit the center beside their home, and non-significant between pediatrics and adults like previous study.…”

“…Meta-analysis studies and others explored the high percentage of prescribing errors and emphasized the importance of healthcare centers. [16][17][18][19][20][21][22][23][24] Antibiotic was the most implicated prescribing error at primary healthcare centers. 25,26 Thus, various studies highlighted antibiotic prescribing errors at healthcare facilities.…”

Findings from afar and translation closer to home

“…Another example of relevance for my practice is the work undertaken in Iran examining antibiotic prescribing in an emergency department (ED) . This research examined the impact of having a clinical pharmacist provide a service for the first time to the ED.…”

“…Another example of relevance for my practice is the work undertaken in Iran examining antibiotic prescribing in an emergency department (ED). 3 This research examined the impact of having a clinical pharmacist provide a service for the first time to the ED. One could question, how could these findings be relevant and translated to a setting such as Australia, where these roles are well recognised?…”