Evidence map›Paper›PMID 34635512›Full record

Observational studyBMJ open2021

Characteristics of pharmacist's interventions triggered by prescribing errors related to computerised physician order entry in French hospitals: a cross-sectional observational study.

Manon Videau, Bruno Charpiat, Céline Vermorel, Jean-Luc Bosson, Ornella Conort, Pierrick Bedouch, SFPC VIP– Act-IP group

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Manon VideauPharmacy, Grenoble Alpes University Hospital, Grenoble, France videau.manon@gmail.com.ORCID 0000-0001-8502-237X
Bruno CharpiatCNRS/TIMC-IMAG UMR5525/ThEMAS, F-38041, Université Grenoble Alpes, Grenoble, France.
Céline VermorelCNRS/TIMC-IMAG UMR5525/ThEMAS, F-38041, Université Grenoble Alpes, Grenoble, France.
Jean-Luc BossonCNRS/TIMC-IMAG UMR5525/ThEMAS, F-38041, Université Grenoble Alpes, Grenoble, France.
Ornella ConortPharmacy, Hopital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France.
Pierrick BedouchPharmacy, Grenoble Alpes University Hospital, Grenoble, France.
SFPC VIP– Act-IP group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesComputerised physician order entry (CPOE) systems facilitate the review of medication orders by pharmacists. Reports have emerged that show conception flaws or the misuse of CPOE systems generate prescribing errors. We aimed to characterise pharmacist interventions (PIs) triggered by prescribing errors identified as system-related errors (PISREs) in French hospitals.

designThis was a cross-sectional observational study based on PIs prospectively documented in the Act-IP observatory database from January 2014 to December 2018.

settingPISREs from 319 French computerised healthcare facilities were analysed.

participantsAmong the 319 French hospitals, 232 (72.7%) performed SRE interventions, involving 652 (51%) pharmacists.

resultsAmong the 331 678 PIs recorded, 27 058 were qualified as due to SREs (8.2%). The main drug-related problems associated with PISREs were supratherapeutic (27.5%) and subtherapeutic dosage (17.2%), non-conformity with guidelines/contraindications (22.4%) and improper administration (17.9%). The PI prescriber acceptation rate was 78.9% for SREs vs 67.6% for other types of errors. The PISRE ratio was estimated relative to the total number of PIs. Concerning the certification status of CPOE systems, the PISRE ratio was 9.4% for non-certified systems vs 5.5% for certified systems (p<0.001). The PISRE ratio for senior pharmacists was 9.2% and that for pharmacy residents 5.4% (p<0.001). Concerning prescriptions made by graduate prescribers and those made by residents, the PISRE ratio was 8.4% and 7.8%, respectively (p<0.001).

conclusionComputer-related prescribing errors are common. The PI acceptance rate by prescribers was higher than that observed for PIs that were not CPOE related. This suggests that physicians consider the potential clinical consequences of SREs for patients to be more frequently serious than interventions unrelated to CPOE. CPOE medication review requires continual pharmacist diligence to catch these errors. The significantly lower PISRE ratio for certified software should prompt patient safety agencies to undertake studies to identify the safest software and discard software that is potentially dangerous.

Indexed as

Medical Order Entry SystemsCross-Sectional StudiesDrug PrescriptionsHospitalsHumansMedication ErrorsPharmacistsadverse eventshealth informaticshealth & safety

Identifiers

PMID34635512
PMCPMC8506887

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.