Pharmacist participation in prescribing-error prevention among HIV/AIDS patients

Abstract

The objectives of this study were to analyse prescribing errors in the prescribing process of HIV/AIDS patients in term of types, rate and prevalence of error, and to assess the reduction of prescribing error after pharmacist participation on prescribing error prevention. The study was conducted in the HIV clinic at Samutsakhon Hospital. The study was divided into three phases. In phase 1, the prescribing process was observed and prescribing errors were assessed by the investigator during October 1, 2007 to November 15, 2007. In phase 2, pharmacists with physicians and nurses develop the model of pharmacist participation in prescribing error prevention and the model was tested for a 1-month period. In phase 3, The role of pharmacist in the model and prescribing errors were evaluated during December 15, 2007 to January 31, 2008. A total of 249 patients in phase 1 and 254 patients in phase 3 were evaluated. There were 123 prescribing errors in phase 1 but only 8 prescribing errors in phase 3. The error rates were 19.19% in phase 1 and 1.20% in phase 3. Types of errors most commonly found were prescribing medication with the incorrect time (not around the clock)(44.72%), do not specified strength (21.14%), and incorrect indication of opportunistic infections (13.01%). Types of physician associated with prescribing errors were internist (45.45%), general practitioner (23.17%), and medical specialist (13.61%). All pharmacists’ recommendations to physician were accepted, including clarification of order, time changing, and cessation of drug. The results indicated that substantial reduction of prescribing error rate came from pharmacist participation prior to physician prescribing which included reviewing the regimen, identifying the name of antiretroviral regimen using self-inking stamp, calculating the quantity of medication, and preparing the medication. This study recommended that collaboration with physicians and nurses to develop the system that enhances pharmacist participation in prescribing error prevention will ensure that patients are safe and receive appropriate drug therapy.