Impact of Laboratory Data Integration into Outpatient Prescriptions on Community Pharmacist Feedback and Physician...

Laboratory data with outpatient prescriptions have expanded, and their usefulness has been reported. However, the effect of a modification in laboratory data provision on the content of tracing reports (TRs) submitted by community pharmacists to provide clinical feedback to physicians and on physician responses remains unclear. This study aimed to evaluate the impact of a system-level modification in laboratory data provision on the inclusion of laboratory data-related descriptions in TRs and to assess the association between TR characteristics and physician responses.

We used TRs submitted by community pharmacies to a university hospital in Japan. An integrated prescription format (IPF), containing laboratory data automatically printed on prescriptions, was introduced in addition to the existing separate sheet format (SSF). Laboratory data-related descriptions in the TRs were compared pre- and post-implementation. Physician responses were evaluated, and associated factors were analyzed using logistic regression.

Laboratory data provision using SSF remained approximately 4% pre- and post-implementation, whereas IPF printed laboratory data fields on all prescriptions post-implementation. A total of 761 TRs were analyzed (pre-implementation, 389; post-implementation, 372). Laboratory data-related descriptions were identified in 16 TRs (2.1%), with a significant increase post-implementation (1.0% vs 3.2%; odds ratio [OR] 3.21, 95% confidence interval [CI] 1.03-10.04). Physician responses were recorded for 210 TRs (27.6%), with no significant difference pre- and post-implementation (27.8% vs 27.4%; OR 0.98, 95% CI 0.71-1.35). Multivariable analysis showed a strong association between pharmacists' proposals or concerns and physician responses (adjusted OR 10.39, 95% CI 5.39-20.03).

The IPF-based laboratory data provision system increased inclusion of laboratory data-related descriptions in TRs but not physician responses. The findings suggest that providing information that includes clinically relevant proposals or concerns, rather than simply increasing the amount of information available, may be more important for promoting physician responses.