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General and Risk Management, Patient Safety (including: medication errors, quality control)
How great is the clinical impact of pharmacist interventions on prescriptions?
  1. J. Barthelat,
  2. R. Reboul,
  3. C. Delom,
  4. C. Dumazer,
  5. J. Rocquain
  1. 1Centre Hospitalier D’Aubagne, Pharmacy, Aubagne, France

Abstract

Background The public hospital of Aubagne (South of France) records about 15 000 patients each year. New prescriptions are scrupulously examined by pharmacists every day. This routine analysis leads to pharmaceutical notifications (PNs) if any anomalies are detected.

Purpose The aim of this study is to retrospectively analyse the impact of these PNs over 3 months (from July to September 2011) in five clinical departments (internal medicine, geriatrics, pneumology, cardiology and cardiology intensive care).

Materials and methods PNs were added to digital prescriptions during the validation process and therefore could be read at any time by clinicians. They were divided into five categories: indications, inadequate posologies due to physio-pathologic characteristics (renal failure, older people), medical interactions, duplicated prescriptions, and clerical errors (inappropriate unit or dosage). Data required to validate the prescriptions were collected on DOME software (stores clinical data, examination records, biological analyses) and THERIAQUE database (stores drug information).

Results 102 PNs were issued out of 722 prescriptions delivered in 3 months, which represents about nine PNs per 1000 prescription lines. At the beginning of the study, the main problem was related to inadequacy of the posology (43.2% of PNs): thanks to pharmaceutical vigilance and collaboration between health professionals, this rate dropped to 15.4% in September. Moreover errors on inappropriate indications decreased from 18.9% to 12.8%, while other indicators did not show significant results. Overall, PN led to modifications of prescriptions in nearly 50% of cases.

Conclusions This study shows how a meticulous examination of prescriptions by pharmacists can be efficient in preventing iatrogenic harm. In the future the authors hope to improve acceptance of these PNs by developing closer links between health teams.

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