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International Journal of Clinical Pharmacy

, Volume 39, Issue 5, pp 1013–1017 | Cite as

Exploring the impact of feedback on prescribing error rates: a pilot study

  • Michael LloydEmail author
  • Simon David Watmough
  • Sarah Victoria O’Brien
  • Kevin Hardy
  • Niall Furlong
Short Research Report

Abstract

Background Prescribing errors are prevalent in hospital settings with feedback identified as one potential error reduction strategy. Hospital pharmacists work alongside prescribers at ward level and are credible facilitators of prescribing error feedback. A formalised programme of pharmacist-led prescribing error feedback was designed and implemented Objective To determine the impact of the feedback intervention on prescribing error rates. Method Prospective prescribing audits were undertaken at baseline for control (n = 11) and intervention group (n = 10) prescribers. The intervention group received pharmacist-led, individualised constructive feedback on their prescribing, whilst the control group continued with existing practice. Prescribing was re-audited following 3-months of the intervention. Data were analysed using chi-squared and independent t-tests. Results Error frequency (123/641 intervention and 121/649 control) was comparable between groups at baseline (p = 0.819) with significant differences (90/1677 intervention and 236/984 control) post intervention (p = <0.005). Prescribing error rates were lower in the intervention group (mean change of −11.5%) and higher in the control group (mean change of +5.9%) following the intervention, with a mean significant difference of 17.4% (SD 4.7, 95% CI, −27.3 to −7.6), t = −3.694, p < 0.05, between groups. Conclusion Pharmacist-led prescribing error feedback positively influences prescribing. This intervention shows promise for wider application in hospital settings to optimise patient safety.

Keywords

Feedback Pharmacist Prescriber Prescribing error Reduction United Kingdom 

Notes

Acknowledgements

The authors would like to thank all pharmacists and doctors who have participated in this study.

Funding

No funding was received for the study.

Conflicts of interest

The authors declare that they have no conflict of interest.

Supplementary material

11096_2017_503_MOESM1_ESM.doc (33 kb)
Supplementary material 1 (DOC 33 kb)
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Supplementary material 2 (DOCX 19 kb)
11096_2017_503_MOESM3_ESM.docx (19 kb)
Supplementary material 3 (DOCX 19 kb)

References

  1. 1.
    Dornan T, Ashcroft D, Heathfield H, Lewis P, Miles J, Taylor D, et al. An in-depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education. EQUIP Study. General Medical Council, 2009. http://www.gmc-uk.org/about/research/research_commissioned.asp Accessed 15 Jan 2017.
  2. 2.
    Reynolds M, Jheeta S, Benn J, Sanghera I, Jacklin A, Ingle D, et al. Improving feedback on junior doctors’ prescribing errors: mixed-methods evaluation of a quality improvement project. BMJ Qual Saf. 2017;26(3):240–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Ivers N, Jamtvedt G, Flottorop S, Young JM, Odgaard-Jensen J, French SD, et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012; 6:CD000259. Accessed at http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000259.pub3/pdf/standard. Last Accessed 1 March 2017.
  4. 4.
    Ende J. Feedback in clinical medical education. JAMA. 1983;250:777–81.CrossRefPubMedGoogle Scholar
  5. 5.
    Lloyd M, Watmough SD, O’Brien SV, Furlong N, Hardy K. Exploring attitudes and opinions of pharmacists towards delivering prescribing error feedback: a qualitative case study using focus group interviews. Res Soc Adm Pharm. 2016;12(3):461–74.CrossRefGoogle Scholar
  6. 6.
    Lloyd M, Watmough SD, O’Brien SV, Furlong N, Hardy K. A pilot study exploring doctor attitudes and opinions to receiving formalised prescribing error feedback from hospital pharmacists. Br J Hosp Med. 2015;76:713–8.CrossRefGoogle Scholar
  7. 7.
    Aronson JK. Medication errors. Definition and classification. Br J Clin Pharmacol. 2009;67(6):599–604.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Ramani S, Krackov SK. Twelve tips for giving feedback effectively in the clinical environment. Med Teach. 2012;34:787–91.CrossRefPubMedGoogle Scholar
  9. 9.
    Brennan N, Mattick K. A systematic review of educational interventions to change behaviour of prescribers in hospital settings, with a particular emphasis on new prescribers. Br J Clin Pharmacol. 2013;75:359–72.CrossRefPubMedGoogle Scholar
  10. 10.
    Ferguson J, Keyworth C, Tully MP. If no-one stops me, I’ll make the mistake again’: changing prescribing behaviours through feedback; a perceptual control theory perspective. Res Soc Adm Pharm. 2017;1–7. doi: 10.1016/j.sapharm.2017.03.001.

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Pharmacy DepartmentSt. Helens and Knowsley Teaching Hospitals NHS TrustWhiston, MerseysideUK
  2. 2.Postgraduate Professional Development, Faculty of Health and Social CareEdge Hill UniversityOrmskirkUK
  3. 3.St. Helens CCGSt. Helens ChambersMerseysideUK
  4. 4.St. Helens and Knowsley Teaching Hospitals NHS TrustWhiston, MerseysideUK

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