Electronic prescription anomalies: a study of frequencies, clarification and effects in Finnish community pharmacies

Abstract

Objectives To investigate the frequency of e‐prescriptions containing prescription anomalies (=errors, ambiguities and other shortcomings), and the types of e‐prescription anomalies occurring in Finnish community pharmacies. Further objectives were to investigate how these anomalies were clarified, together with the time required, as well as the effects such anomalies had in the pharmacies concerned. Methods During the 3‐day study period in 2017, 54 community pharmacies reported all e‐prescription anomalies found by pharmacists during medicine dispensing. Key findings Of the 41 170 e‐prescriptions dispensed during the study period, 2978 (7.2%) contained anomalies. The most common anomalies were the fact that the dosage instructions were written using abbreviations (63.7%) and that the purpose of the medicine was missing altogether (28.4%). In most cases where the e‐prescription contained anomalies (85.9%) the anomalies were clarified. Most anomalies were clarified at the pharmacy by writing out the abbreviations in the dosage instructions (69.6%) or with the customer (23.4%). The average time taken by pharmacists to clarify the anomalies was 1.8 min per e‐prescription. Anomalies caused problems in 39.6% of the cases. Most often, the anomalies increased the pharmacy's workload (55.9%) and it took longer to serve the customer (51.4%). Conclusions E‐prescription anomalies are quite common in Finland, indicating that there is a need to improve the quality of e‐prescribing. The e‐prescribing system should be further developed to encourage prescribers to issue more complete e‐prescriptions and in this way improve medication safety and make medicine dispensing easier and more efficient.

From Paper to E-Prescribing of Multidose Drug Dispensing: A Qualitative Study of Workflow in a Community Care Setting

“…In recent years, the use of e-prescribing has increased significantly in Europe, especially in the Nordic countries, Estonia, and the Netherlands [ 7 ]. It is also widely used in the United States, Australia, and Canada [ 8 ]. E-prescribing improves the eligibility and clarity of prescriptions [ 4 , 5 , 6 ], reduces prescribing errors [ 4 ], improves coordination, and ensures the privacy and security of personal health information [ 9 ].…”

“…E-prescribing improves the eligibility and clarity of prescriptions [ 4 , 5 , 6 ], reduces prescribing errors [ 4 ], improves coordination, and ensures the privacy and security of personal health information [ 9 ]. However, it can also create new errors, such as incorrect dosage instructions, missing information, incorrect product (medicine or strength), and wrong quantity or duration of therapy [ 1 , 8 , 10 , 11 ].…”

Digital Health in Physicians' and Pharmacists' Office: A Comparative Study of e-Prescription Systems' Architecture and Digital Security in Eight Countries

“…Accordingly, the pharmacy's workload will increase from interpreting the pharmacist's e-Prescriptions' anomalies, which will affect the overall quality of service. In the above anomalies cases, the pharmacy's workload increased by 39%, which led to an increase in the wait time for the patient (Timonen et al, 2018 ).…”

“…In addition, e-Prescription will improve the low service quality associated with paper prescriptions by decreasing the amount of work needed to sort the related paperwork. More importantly, providing a medication history for each patient will enhance the patient safety while prescribing medication (Aldughayfiq and Sampalli, 2018 ; Byrne et al, 2010 ; Devine et al, 2010 ; Kohn, 2011 ; Odukoya and Chui, 2013 ; Samadbeik et al, 2013 ; Taylor et al, 2008 ; Timonen et al, 2018 ; Van Dijk et al, 2011 ; Wang et al, 2009 ). However, not all medication errors are entirely preventable by e-Prescriptions.…”

“…However, not all medication errors are entirely preventable by e-Prescriptions. Moreover, there are risks related to the prescriber's adaptation of the e-Prescription system, since they need to familiarize themselves with the e-Prescription software (Odukoya and Chui, 2013 ; Timonen et al, 2018 ).…”