Prescriptions from general practitioners and in hospital physicians requiring pharmacists' interventions

Purpose: To study prescribing errors requiring pharmacists' interventions and to evaluate the potential clinical significance of the errors and omissions detected.

Methods: The pharmacists at ten community pharmacies and two out-patient hospital pharmacies recorded prescribing errors and corresponding interventions using a modified version of a previously developed registration scheme. Prescription errors with potential clinical significance were scored according to a modified version of Safety Assessment Code (SAC)-score

Results: During the study period 85,475 prescriptions were dispensed. A total of 2385 prescribing errors were detected on 2226 (2.6%) prescriptions. The proportion of prescriptions with errors and omissions was more than four times higher on prescriptions from hospital physicians (7.1%) than on prescriptions from general practitioners (1.5%). The information on the majority (62.2%) of the prescriptions with inaccuracies had to be clarified before the drug could be dispensed. About 1/4 of the errors and omissions were of potential importance for the drug therapy. An expert panel of physicians and pharmacists judged 85% of these errors and omissions to be clinically significant. Individual physicians and pharmacists judged the clinical importance of the detected prescribing errors somewhat differently.

Conclusions: Pharmacists intervened on 2.6% of prescriptions, and the majority of the potentially clinically significant prescribing errors were judged as significant to the patient's drug therapy and safety.