From physician intent to the pharmacy label: prevalence and description of discrepancies from a cross-sectional evaluation of electronic prescriptions

Abstract

Discrepancy rates between the prescriber's note and the e-prescription were similar to the discrepancy rates between the e-prescription and pharmacy label. To reduce outpatient medication errors, a better understanding is needed of the sources of discrepancies that occur within the prescriber's clinic, and those that occur between the clinic and pharmacy.

The current state of e-prescribing: Implications for advanced practice registered nurses

“…Both systems prevented more errors than they generated. It was determined that system‐related errors are frequent but few are detected, and contrary to Cochran et al's () recommendation, systems with fewer drop‐down menus to reduce error risk was recommended.…”

“…The literature chosen (Table S1) included three literature reviews (Lapane, Quilliam, & Dore, ; Manchikanti, Whitfield, & Pallone, ; Odukoya & Chui, ), three systematic reviews (Clyne, Bradley, Hughes, Fahey, & Lapane, ; Gagnon, Nsangou, Payne‐Gagnon, Grenier, & Sicotte, ; Motulsky, Lamothe, & Sicotte, ), one review of federal regulation (Schneider & Schneider, ), four descriptive analyses (Gabriel et al., ; Hincapie et al., ; Joseph, Sow, Furukawa, Posnak, & Daniel, ; Westbrook et al., ), three surveys (Amirfar et al., ; Jariwala et al., ; Thomas et al., ), four qualitative interview studies (Abramson et al., ; Bergeron et al., ; Bramble et al., ; Grossman, Cross, Boukas, & Cohen, ), one cross‐sectional study (Cochran et al., ), one time‐motion study (Hollingworth et al., ), and two expert commentaries (Figge, Fox, & Tribble, ; Odukoya & Chui, ). Table S1 provides full details regarding the literature, including author, purpose, methods, results, and conclusions.…”

“…Cochran et al () performed a retrospective cross‐sectional study of 200 new e‐prescriptions at three different pharmacies ( n = 600) to describe eRx vulnerabilities by estimating the prevalence of unintended discrepancies. Discrepancies were found between the prescriber's EHR note, the actual e‐prescription, and the pharmacy prescription label; and these discrepancies were most frequently associated with use of free‐text data fields instead of drop‐down menu options.…”

Automatic Errors: A Case Series on the Errors Inherent in Electronic Prescribing

“…[9][10][11][12][13] Cochran et al found a 2.5 % discrepancy rate between clinic eprescriptions and pharmacy labels. 14 Nanji and colleagues characterized the unrealized potential and residual consequences of e-prescribing. 15 Limitations in communication were described, highlighting the unidirectional (prescriber to pharmacy) flow of electronic information.…”

228 Comparison of Primary Compliance in Electronic Versus Paper Prescriptions Prescribed From the Emergency Department

“…They found the combined error rate of these 3 sources to be 2.2%. 30 In England, Abdel-Qader et al found that 8.4% of e-prescriptions dispensed at the time of discharge from the hospital necessitated pharmacist intervention. 31 Kaushal et al and Ammenworth et al both…”