Is the Pharmacist "Safety Net" Effective in Preventing Prescribing Errors?

Introduction
Pharmacists play an important role in identifying prescribing errors, but their ability in correctly detecting errors is not well understood. We investigated the ability of pharmacists in detecting prescribing errors, and whether feedback improved their ability to do so.

Methodology
A quasi-experimental study was conducted in a proportionate random sample of 18 public specialist hospitals, district hospitals, and health clinics in Perak. The study population was pharmacists involved in dispensing medications at the paediatric outpatient setting. A pharmacist was appointed at each site to review prescriptions of patients aged 12 years and below. Data were collected during the first (baseline), third, and fifth (end of study) months of the study. Personalised feedback was provided to pharmacists following data collection at baseline and fifth month of the study. The primary endpoint was the difference in the percentage of prescriptions with errors missed by pharmacists between baseline and end of study.

Results
A total of 6,076 prescriptions were reviewed. At baseline, 17.1% prescriptions had errors, and pharmacists correctly detected 11.4%. At the end of the study, the percentage of prescriptions with error reduced to 10.4%, and pharmacists correctly detected 8.5%. Following provision of feedback, the ability of pharmacists to detect errors improved, as the percentage of prescriptions with errors missed was 5.7% at baseline and 1.9% at end of study (difference 3.8%, 95% CI: 2.5%, 5.1%).

Discussion/Conclusion
Pharmacists must not be assumed as a complete safety net to detect and prevent prescribing errors. Continuous monitoring is essential to ensure patient safety.