Physician noncompliance with prescription-writing requirements

Prescriptions processed in an outpatient pharmacy department (OPD) were audited retrospectively for physician noncompliance with prescription-writing requirements, and the estimated cost in pharmacist and patient time attributable to the errors made was assessed. During a 14-day period, 7858 prescriptions written by 451 physicians and taken to the OPD of a large teaching hospital were examined. When the patient's name, physician's signature, drug quantity, or directions for use were omitted, patients were asked to return the prescription in person for correction. In a follow-up study, the time spent at the clinic for this purpose was recorded for 50 patients. For another sample of 52 prescriptions corrected by a pharmacist's telephone call to the physician, pharmacist time spent was recorded. Errors were found in 1070 prescriptions. The total number of errors was 1130, for a noncompliance rate of 14.38%. The most frequent errors were ordering of nonformulary drugs and erroneous or unspecified dosage strength. There was no difference in noncompliance among physicians with various levels of training. An average of 25 patients per day were asked to return to the clinic for correction of their prescriptions; more than half did not return to the OPD. For the 50 patients whose return visits were monitored, time spent in the clinic area was 15.0 +/- 9.1 minutes. For the 52 prescriptions corrected by telephone calls to physicians, the pharmacist spent 10.3 +/- 11.0 minutes. Under these study conditions, pharmacists spent 16.3 hours per day correcting prescription errors; if asked to return all unfillable prescriptions, patients would have spent 23.7 hours per day. Pharmacy departments might reduce these time expenditures by conducting periodic reviews of prescription errors and apprising physicians of frequent areas of noncompliance.