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Medication prescribing errors: a pre- and post-computerized physician order entry retrospective study.

Naïs Rouayroux1, Violaine Calmels2, Bérengére Bachelet2

  • 1Clinical Pharmacy Department, Toulouse University Hospital Centre, 1 Avenue du Professeur Jean Poulhès, 31059, Toulouse, France. nais.rouayroux@gmail.com.

International Journal of Clinical Pharmacy
|November 18, 2018
PubMed
Summary
This summary is machine-generated.

Computerized physician order entry systems reduce traditional prescribing errors but introduce new system-related ones. These system errors decrease over time and are not more severe than other errors.

Keywords:
CPOEClinical pharmacyComputerized physician order entryFrancePharmaceutical interventionsPrescribing errors

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Area of Science:

  • Health Informatics
  • Clinical Pharmacy
  • Patient Safety

Background:

  • Computerized physician order entry (CPOE) systems aim to improve medication safety.
  • However, CPOE implementation can introduce new types of prescribing errors.
  • The long-term impact of CPOE on error profiles requires careful evaluation.

Purpose of the Study:

  • To assess the impact of CPOE on prescribing errors immediately after implementation and one year later.
  • To compare the incidence and clinical impact of CPOE-related errors versus traditional errors.

Main Methods:

  • A prospective analysis of prescriptions in Cardiology and Diabetology departments over three years.
  • Pharmaceutical interventions were used to identify and categorize prescribing errors.
  • Statistical comparisons (t-tests, Kruskal-Wallis) were performed on intervention counts and clinical impacts.

Main Results:

  • Overall pharmaceutical interventions decreased from 14.1/100 patient days (implementation) to 9.6/100 patient days (1 year post-implementation).
  • Computerization-related errors decreased significantly (p=0.04) from implementation to 1 year later.
  • Traditional (non-computerization-related) errors also decreased (p=0.02) over the study period.

Conclusions:

  • CPOE implementation initially introduces specific system-related errors.
  • The number of these system-related errors diminishes significantly within one year.
  • CPOE systems ultimately contribute to a reduction in overall prescribing errors without increasing error severity.