Article Text

Download PDFPDF

5PSQ-032 Use of the ‘precautionary annulments’ tool by a hospital pharmacy service
  1. M Rodriguez Jorge,
  2. R Serrano Giménez,
  3. T Blanco Espeso,
  4. M Florido Francisco


Background and Importance The main objective of precautionary annulments (PA) is to contribute to patient safety, preventing dispensing of erroneous medications at the outpatient pharmacy level. This is a new tool carried out by both hospital and primary care pharmacists.

Aim and Objectives To analyse the different PA conducted by hospital pharmacists, and to evaluate their degree of acceptance by doctors.

Material and Methods This is a prospective study, carried out from May to September 2023. All patients in whom a PA was carried out, either during a hospital admission or by proactively obtaining the information through the ‘Microstrategy’ database, were included.

Variables collected age, sex, therapeutic group of the drug and prescribing service.

The PA were distinguished according to whether they were therapeutic duplications, dosing errors, or inappropriate medication prescription. Finally, the degree of acceptance by the physicians was measured.

Data obtained through the e-prescription module, digital medical record and through the ‘Microstrategy’ database.

Results A total of 38 patients were included (with one PA each). 60.5% were women (n=23), with a median age of 56 years (IQR=69–41).

In terms of therapeutic group, the highest percentage of PA was in the group of anti-rheumatics (28.9%), followed by anti-ulcers (18.5%), anti-osteoporosis (15.9%) and anti-diabetics (10.5%). Other drugs cancelled were: vitamins (5.3%), anti-anginal drugs (5.3%), anti-anaemics (2.6%), anti-asthmatics (2.6%), antipsychotics (2.6%), antihypertensives (2.6%), pancreatic deficiency substitutes (2.6%), and medical devices (2.6%).

The prescribers were primary care physicians (39.5%), rheumatologists (13.2%), gastroenterologists (10.5%), gynaecologists (10.5%), internists (8%), paediatricians (5.3%), rehabilitators (2.6%), cardiologists (2.6%), psychiatrists (2.6%), oncologists (2.6%) and vascular physicians (2.6%).

In the anti-rheumatics group (n=11), the drug discontinued in all of them was methotrexate. Of all the PA in this group, six had not yet been renewed by the prescribing physician, so the patient is currently unable to take the treatment.

Regarding the type of error that led to the PA, 65.8% were due to dosage errors; 26.3% to therapeutic duplications and 7.9% to inappropriate prescribing.

Of all the PA made, only 39.5% were accepted by the prescribing physician; the rest were discontinued because the cancellation period had expired without response.

Conclusion and Relevance Although PA are intended to improve patient safety, it is important that they are well reviewed and accepted by the prescribing physician.

Of particular note are the PA carried out for methotrexate, a drug considered high-risk according to ISMP (Institute for Safe Medication Practices) Spain.

Conflict of Interest No conflict of interest.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.