Electronic prescription anomalies: a study of frequencies, clarification and effects in Finnish community pharmacies

Abstract

Objectives: To investigate the frequency of e-prescriptions containing prescription anomalies (=errors, ambiguities and other shortcomings), and the types of e-prescription anomalies occurring in Finnish community pharmacies. Further objectives were to investigate how these anomalies were clarified, together with the time required, as well as the effects such anomalies had in the pharmacies concerned. Methods: During the 3-day study period in 2017, 54 community pharmacies reported all e-prescription anomalies found by pharmacists during medicine dispensing. Key findings: Of the 41 170 e-prescriptions dispensed during the study period, 2978 (7.2%) contained anomalies. The most common anomalies were the fact that the dosage instructions were written using abbreviations (63.7%) and that the purpose of the medicine was missing altogether (28.4%). In most cases where the e-prescription contained anomalies (85.9%) the anomalies were clarified. Most anomalies were clarified at the pharmacy by writing out the abbreviations in the dosage instructions (69.6%) or with the customer (23.4%). The average time taken by pharmacists to clarify the anomalies was 1.8 min per e-prescription. Anomalies caused problems in 39.6% of the cases. Most often, the anomalies increased the pharmacy’s workload (55.9%) and it took longer to serve the customer (51.4%). Conclusions: E-prescription anomalies are quite common in Finland, indicating that there is a need to improve the quality of e-prescribing. The e-prescribing system should be further developed to encourage prescribers to issue more complete e-prescriptions and in this way improve medication safety and make medicine dispensing easier and more efficient.