Electronic prescribing

The last research roundup provided you with an overview of nurse and midwife prescribing. The articles reviewed looked at the principles of prescribing practice and the implementation and evaluation of nurse prescribing as well as exploring attitudes and beliefs (Robertson, 2021). The papers chosen offered a global perspective rather than being UK centric. This month we are looking at the areas of prescribing errors and of electronic prescribing. Prescribing errors do happen, and electronic prescribing has been seen by some as a way to reduce prescribing errors. The following studies look at prescribing error rates between doctors and pharmacists in one trust and then at errors using an electronic prescribing system for discharge prescriptions. The final paper looks at the impact of electronic prescribing on prescribing opioids and the issue of overprescribing.

This original research article published in the European Journal of Hospital Pharmacy aimed to investigate any differences in rates of prescribing errors made by medical prescribers as compared to independent prescribing pharmacists (Turner et al, 2020). The authors found that there was a lack of information or evidence in the literature surrounding errors in independent pharmacist prescriptions despite the profession having had prescribing rights equivalent to medical professionals since 2009. They wished to elucidate the type and frequency of prescribing errors in this professional group. The study was conducted in the UK in one NHS trust site and covered a one week period, this data was collected in May 2018. Data collection forms and error definitions as used in the EQUIP study (a large study to identify prescribing errors in junior doctors) were employed. All prescriptions in that period validated as being from an independent pharmacist prescriber or a junior doctor were included. This amounted to 5840 prescriptions in total with 1026 of those being from independent pharmacist prescribers (amounting to 17.6% of total prescriptions). Of these 5840 prescriptions, 479 were found to contain errors under the definitions of the EQUIP study coding. The researchers found that overall pharmacist prescribers had an error rate of 0.7% with the error rate among junior doctors prescriptions being considerably higher at 9.8%. Furthermore, they were able to differentiate between recently qualified pharmacist prescribers and those with more experience in prescribing. This revealed that the less experienced prescribers had 0% errors and the more experienced had a 1% error rate. Continued examination of the data revealed that 85.7% of the pharmacist prescriber errors were coded as minimally significant in comparison to that coding being attributed to only 31.7% of junior doctors’ errors. In all prescribing errors, only 0.4% resulted in actual patient harm.