The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study
Objectives: To compare prevalence and types of dispensing errors and pharmacists’ labelling enhancements, for prescriptions transmitted electronically versus paper prescriptions. Design: Naturalistic stepped wedge study. Setting: 15 English community pharmacies. Intervention: Electronic transmiss...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
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BMJ Publishing Group
2014
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| Online Access: | https://eprints.nottingham.ac.uk/49251/ |
| _version_ | 1848797956994498560 |
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| author | Franklin, Bryony Dean Reynolds, Matthew Sadler, Stacey Hibberd, Ralph Avery, Anthony J. Armstrong, Sarah J. Mehta, Rajnikant Boyd, Matthew J. Barber, Nick |
| author_facet | Franklin, Bryony Dean Reynolds, Matthew Sadler, Stacey Hibberd, Ralph Avery, Anthony J. Armstrong, Sarah J. Mehta, Rajnikant Boyd, Matthew J. Barber, Nick |
| author_sort | Franklin, Bryony Dean |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objectives: To compare prevalence and types of dispensing errors and pharmacists’ labelling enhancements, for prescriptions transmitted electronically versus paper prescriptions.
Design: Naturalistic stepped wedge study.
Setting: 15 English community pharmacies.
Intervention: Electronic transmission of prescriptions between prescriber and pharmacy.
Main outcome measures: Prevalence of labelling errors, content errors and labelling enhancements (beneficial additions to the instructions), as identified by researchers visiting each pharmacy.
Results: Overall, 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.
Conclusions: We 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. |
| first_indexed | 2025-11-14T20:12:07Z |
| format | Article |
| id | nottingham-49251 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:12:07Z |
| publishDate | 2014 |
| publisher | BMJ Publishing Group |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-492512020-05-04T16:50:00Z https://eprints.nottingham.ac.uk/49251/ The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study Franklin, Bryony Dean Reynolds, Matthew Sadler, Stacey Hibberd, Ralph Avery, Anthony J. Armstrong, Sarah J. Mehta, Rajnikant Boyd, Matthew J. Barber, Nick Objectives: To compare prevalence and types of dispensing errors and pharmacists’ labelling enhancements, for prescriptions transmitted electronically versus paper prescriptions. Design: Naturalistic stepped wedge study. Setting: 15 English community pharmacies. Intervention: Electronic transmission of prescriptions between prescriber and pharmacy. Main outcome measures: Prevalence of labelling errors, content errors and labelling enhancements (beneficial additions to the instructions), as identified by researchers visiting each pharmacy. Results: Overall, 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. Conclusions: We 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. BMJ Publishing Group 2014-08-01 Article PeerReviewed Franklin, Bryony Dean, Reynolds, Matthew, Sadler, Stacey, Hibberd, Ralph, Avery, Anthony J., Armstrong, Sarah J., Mehta, Rajnikant, Boyd, Matthew J. and Barber, Nick (2014) The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study. BMJ Quality & Safety, 23 (8). pp. 629-638. ISSN 2044-5423 http://qualitysafety.bmj.com/content/23/8/629 doi:10.1136/bmjqs-2013-002776 doi:10.1136/bmjqs-2013-002776 |
| spellingShingle | Franklin, Bryony Dean Reynolds, Matthew Sadler, Stacey Hibberd, Ralph Avery, Anthony J. Armstrong, Sarah J. Mehta, Rajnikant Boyd, Matthew J. Barber, Nick The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study |
| title | The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study |
| title_full | The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study |
| title_fullStr | The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study |
| title_full_unstemmed | The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study |
| title_short | The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study |
| title_sort | effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in english community pharmacies: a naturalistic stepped wedge study |
| url | https://eprints.nottingham.ac.uk/49251/ https://eprints.nottingham.ac.uk/49251/ https://eprints.nottingham.ac.uk/49251/ |