Collaborative prescribing sees hospital pharmacists achieve a 90% error-free rate on medication orders compared with 26% for medical officers
Pharmacists in the emergency department and admissions unit setting have been found to be more accurate at making medication orders than their medical officer counterparts – under specific conditions.
The Australian study, conducted by researchers from the Metro North Hospital and Health Service in Brisbane, reviewed collaborative pharmacist-prescribed charts for 17 patients and medical officer-prescribed charts for another 17 patients.
This equated to 146 medication orders written by a pharmacist and 145 written by a medical officer.
Where the pharmacist acted as prescriber, a pharmacist completed the medication history as is usual practice, documented on a medication action plan.
The prescribing pharmacist then collated recommendations on continuation, withholding or ceasing usual medicines.
Medication history and recommendations were discussed with the admitting medical officer to agree on a medication plan.
Medication charts were reviewed by the usual ward pharmacist, as is usual practice, to perform medication reconciliation.
Meanwhile when the medical officer acted as prescriber, the medication history was taken by a pharmacist either before or after the medication chart of ongoing medicines had been completed.
The admitting medical officer was in charge of prescribing the medication chart.
There were three errors identified in the pharmacist prescriber group (2% chance of error per medication order) and 23 errors identified in the medical officer prescriber group (16% chance of error per medication order).
In the pharmacist-prescribed charts, one error was considered to have high potential for patient harm (<1% chance of medium-very high risk error per medication order), whereas the other two issues were considered low risk.
In the medical officer-prescribed charts, 15 of 23 orders (65%) were considered to have a medium, high or very high risk of patient harm (10% chance of medium-very high risk error per medication order).
When assessed using the national inpatient medication chart (NIMC) audit tool, 90% of medication orders written by the pharmacist were considered error free.
The error-free rate for medical officers was 26%.
“Pharmacist prescribing is in the early stages of practice in the Australian setting,” said the researchers.
“The present small study demonstrates that pharmacist prescribing of regular medicines for general medical patients is safer and more accurate than medical officer prescribing.”
The study was published in the Journal of Pharmacy Practice and Research.