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Pharmacy World and Science

, Volume 23, Issue 3, pp 98–101 | Cite as

Determinants of pharmacists' interventions linked to prescription processing

  • H.G.M. Leufkens
  • M.P.D. Westein
  • R.M.C. Herings
Article

Abstract

Aim of study: The role of pharmacists in today's healthcare is changing rapidly. As they are close to the prescribing process, pharmacists are in the position to identify and adjust prescribing errors before dispensing. The objective of this study was to identify relevant determinants of interventions directly linked to prescription processing in community pharmacy. Methods: As part of a yearly continuing education programme, all community pharmacies in the region of 'Zeeland' (N=23) in the south‐west of The Netherlands kept detailed records of all interventions directly linked to prescription processing during one week in May 1998. For every patient involved in an intervention, a control‐patient was matched on pharmacy practice, date, gender and age. Results: A total of 39,357 prescriptions were evaluated by the 23 pharmacies during the one‐week intervention programme. Out of these, one out of 10 resulted into an intervention. Being a first prescription in a new treatment episode was found to be a significant determinant (OR 1.75, 95 CI% 1.18‐2.33). Variables reflecting drug therapy complexity (> 3 prescribers, > 15 prescriptions in 3 months before, > 3 different medications) showed all ORs higher than 1.00, but not significant. When looking at the individual drug categories, anti‐infectives, respiratory drugs and cardiovascular medicines came out as important drug classes for intervention risk. We could not find any association between the number of signals per pharmacy and the number of interventions. Conclusion: The 'whistle‐blower'‐ model of pharmacy based interventions is a valid one but needs a targeted and integral way of implemented thinking and use of information technology. In such an environment, interventions are a logical step of in‐process quality control in the drug usage system.

Community pharmacy Drug related problems Medication surveillance Pharmacoepidemiology Pharmaceutical care 

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References

  1. 1.
    Lipton HL. Pharmacists as agents of change for rational drug therapy. Int J Technol Assess Health Care 1995; 11: 485-508.Google Scholar
  2. 2.
    Mil JWF van, Tromp ThFJ, McElnay JC, Jong-van den Berg LTW van den, Vos R. Development of pharmaceutical care in The Netherlands: Pharmacy's contemporary focus on the Patient. J Am Pharm Assoc 1999;39:395-401.Google Scholar
  3. 3.
    Gier JJ de. The electronic pharmaceutical dossier (EPD): an effective aid to documenting pharmaceutical care data. Pharm World Sci1996;18:241-3.Google Scholar
  4. 4.
    Rupp MT. Value of community pharmacists' interventions to correct prescribing errors. Ann Pharmacother 1992;26:1580-4.Google Scholar
  5. 5.
    Dobie RL, Rascati KL. Documenting the value of pharmacist interventions. Am Pharm 1994;34:50-541.Google Scholar
  6. 6.
    Johnson JA, Bootman JL. Drug-related morbidity and mortality. Arch Intern Med 1995;155:1949-56.Google Scholar
  7. 7.
    Prince BS, Goetz CM, Rihn TL, Olsky M. Drug-related emergency department visits and hospital admissions. Am J Hosp Pharm 1992;49:1696-700.Google Scholar
  8. 8.
    Nelson KM, Talbert RL. 1996. Drug-related hospital admissions. cotherapy1996;16:701-7.Google Scholar
  9. 9.
    Caleo S, Benrimoj DC, Lauchlan R, Stewart K. Clinical evaluation of community pharmacists' interventions. Int J Pharm Pract 1996;221-7.Google Scholar
  10. 10.
    Smith CP, Christensen, D.B. Identification and clarification of drug therapy problems by Indian Health Service Pharmacists. Ann Pharmacotherapy1996;30:119-24.Google Scholar
  11. 11.
    Rupp MT, Schondelmeyer, SW, Wilson, GT, Krause, J.E. Documenting Prescribing Errors and Pharmacist Interventions in Community Pharmacy Practice. Am Pharm 1988;28:574-80.Google Scholar
  12. 12.
    Rupp MT, DeYoung M, Schondelmeyer SW. 1992. Prescribing problems and pharmacist interventions in community practice. Medical Care 1992;30:926-40.Google Scholar
  13. 13.
    Hawksworth GM. Corlett AJ, Wright DJ, Chrystyn H, Clinical pharmacy interventions by community pharmacists during the dispensing process. Br J Clin Pharmacol 1999;47:695-700.Google Scholar
  14. 14.
    Jong JGAM de. De meerwaarde van de apotheek. Apotheekmanagement 1998;12:8-10Google Scholar
  15. 15.
    Lesar LS, Briceland L, Stein DS. Factors related to errors in medication prescribing. JAMA 1997;277:312-7.Google Scholar
  16. 16.
    Hannaoui A, Krass I, Benrimoj SI. Review of computerised patient medication records to determine potential clinical interventions in community pharmacy. Int J Pharm Pract 1996;4:162-7Google Scholar
  17. 17.
    Buurma H, Dik E, Floor A, Hoff O van den, Martens M, Witsen TB van, Egberts ACG, Smet PAGM de. A case control study of the epidemiology of changed prescriptions in Dutch community pharmacies. Poster presented at 28th Annual symposium ESCP: Berlin, October 14-16, 1999.Google Scholar

Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • H.G.M. Leufkens
    • 1
  • M.P.D. Westein
    • 1
  • R.M.C. Herings
    • 1
  1. 1.Department of Pharmacoepidemiology and PharmacotherapyUtrecht Institute for Pharmaceutical Sciences (UIPS)UtrechtThe Netherlands

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