Evidence map›Paper›PMID 24742778›Full record

ArticleBMJ quality & safety2014

The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study.

Bryony Dean Franklin, Matthew Reynolds, Stacey Sadler, Ralph Hibberd, Anthony J Avery, Sarah J Armstrong, Rajnikant Mehta, Matthew J Boyd, Nick Barber

Abstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ quality & safety, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Bryony Dean FranklinCentre for Medication Safety and Service Quality, Pharmacy Department, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK Department of Practice and Policy, UCL School of Pharmacy, London, UK.
Matthew ReynoldsCentre for Medication Safety and Service Quality, Pharmacy Department, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.ORCID http://orcid.org/0000-0002-8152-0870
Stacey SadlerNHS Rushcliffe Clinical Commissioning Group, Easthorpe House, Nottingham, UK.
Ralph HibberdDepartment of Practice and Policy, UCL School of Pharmacy, London, UK.
Anthony J AveryDivision of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK.
Sarah J ArmstrongThe NIHR Research Design Service for the East Midlands, School of Medicine, University of Nottingham, Queens Medical Centre, Nottingham, UK.
Rajnikant MehtaThe NIHR Research Design Service for the East Midlands, School of Medicine, University of Nottingham, Queens Medical Centre, Nottingham, UK.
Matthew J BoydDivision of Social Research in Medicines and Health, University of Nottingham School of Pharmacy, Nottingham, UK.
Nick BarberDepartment of Practice and Policy, UCL School of Pharmacy, London, UK The Health Foundation, London, UK.

Funding

Department of Health
6 · The paper itself

Abstract

objectivesTo compare prevalence and types of dispensing errors and pharmacists' labelling enhancements, for prescriptions transmitted electronically versus paper prescriptions.

designNaturalistic stepped wedge study.

setting15 English community pharmacies.

interventionElectronic transmission of prescriptions between prescriber and pharmacy.

main outcome measuresPrevalence of labelling errors, content errors and labelling enhancements (beneficial additions to the instructions), as identified by researchers visiting each pharmacy.

resultsOverall, we identified labelling errors in 5.4% of 16,357 dispensed items, and content errors in 1.4%; enhancements were made for 13.6%. Pharmacists also edited the label for a further 21.9% of electronically transmitted items. Electronically transmitted prescriptions had a higher prevalence of labelling errors (7.4% of 3733 items) than other prescriptions (4.8% of 12,624); OR 1.46 (95% CI 1.21 to 1.76). There was no difference for content errors or enhancements. The increase in labelling errors was mainly accounted for by errors (mainly at one pharmacy) involving omission of the indication, where specified by the prescriber, from the label. A sensitivity analysis in which these cases (n=158) were not considered errors revealed no remaining difference between prescription types.

conclusionsWe identified a higher prevalence of labelling errors for items transmitted electronically, but this was predominantly accounted for by local practice in a single pharmacy, independent of prescription type. Community pharmacists made labelling enhancements to about one in seven dispensed items, whether electronically transmitted or not. Community pharmacists, prescribers, professional bodies and software providers should work together to agree how items should be dispensed and labelled to best reap the benefits of electronically transmitted prescriptions. Community pharmacists need to ensure their computer systems are promptly updated to help reduce errors.

Indexed as

Drug PrescriptionsElectronic PrescribingEnglandHumansMedication ErrorsPharmaciesState Medicine

Identifiers

PMID24742778
PMCPMC4112418

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