Patient counseling detects prescription errors

Medication errors are part of almost every pharmacist's professional life. They are a consequence of the behavioral habits developed by pharmacists to fill prescriptions efficiently. Outpatient prescription errors at an Indian Health Service pharmacy were reviewed. Mistakes detected after pharmacists had signed off on prescription accuracy were recorded. The errors were separated into two groups: 1) those detected during patient counseling, and 2) those reported after patients left the pharmacy. Patient counseling was the intervening event between the pharmacist's accuracy check and the patient's departure from pharmacy. The review of errors showed that of 323 reported mistakes, 286 (89%) were detected during patient counseling and subsequently corrected. Patient counseling appears to be a valuable tool for intercepting medication errors before they leave the pharmacy. The interactive environment created during the patient encounter probably improves concentration and allows previously overlooked mistakes to be noticed. Pharmacists should be encouraged to develop error detection strategies that are a natural part of the counseling process.