Problem prescriptions in Sweden necessitating contact with the prescriber before dispensing

Area of Science:

• Pharmaceutical care
• Medication safety
• Health services research

Background:

• Pharmacists play a crucial role in identifying and resolving prescription issues to prevent patient harm.
• Unresolved prescription problems can pose significant risks to patient safety and medication outcomes.

Purpose of the Study:

• To investigate prescription problems identified by pharmacists in Sweden requiring prescriber contact.
• To compare intervention rates between public hospital pharmacies (PPHs) and city center pharmacies (CCPs).

Main Methods:

• Trained observers recorded all pharmacist attempts to contact prescribers regarding prescription problems.
• Data analyzed for overall problem distribution and compared between CCPs and PPHs.
• Statistical analyses included chi-square, Spearman's rank-correlation, and Wilcoxon two-sample tests.

Main Results:

• Pharmacists contacted prescribers for 1% of new prescriptions; nearly 60% of issues risked patient safety.
• Intervention rates inversely correlated with pharmacy dispensing volume; PPHs had higher rates than large CCPs.
• Problem rates were lower for women and decreased with increasing patient age.

Conclusions:

• Electronic prescribing systems (CPOE, ETP) reduce some errors but can introduce new ones, impacting patient safety.
• Prescription problem rates vary by prescriber, patient age, and gender, with under-correction in larger pharmacies.
• Despite widespread use of electronic systems, significant potential for improvement exists to eliminate prescribing errors reaching patients.