Outpatient prescribing errors and the impact of computerized prescribing

Area of Science:

• Pharmacology and Pharmaceutics
• Health Services Research
• Patient Safety

Background:

• Medication errors are prevalent in inpatient settings, often mitigated by computerized prescribing.
• Outpatient prescribing errors and the efficacy of electronic prescribing in this domain are less understood.

Purpose of the Study:

• To determine the incidence, nature, and seriousness of outpatient prescribing errors.
• To evaluate the potential impact of computerized prescribing on reducing these errors.

Main Methods:

• A prospective cohort study was conducted across four adult primary care practices in Boston.
• Methods included prescription review, patient surveys, and medical chart reviews to identify medication errors and adverse drug events (ADEs).

Main Results:

• A prescribing error rate of 7.6% was observed across 1879 prescriptions, with frequency and dose errors being most common.
• While basic computerized prescribing did not significantly reduce error rates compared to handwritten prescriptions, advanced features could prevent 95% of potential ADEs.

Conclusions:

• Outpatient prescribing errors are frequent and pose a risk to patient safety.
• Current basic computerized prescribing systems may be insufficient; advanced systems with dose and frequency checks are necessary to prevent harm.