Authors (including presenting author) :
Lai KPL(1), Koo HY(2), Chan PF(1), Mak CK(2), Mak LKK(2), Chao DVK(1)
Affiliation :
(1) Department of Family Medicine and Primary Health Care, United Christian Hospital and Tseung Kwan O Hospital (TKOH), Kowloon East Cluster (2) Department of Pharmacy, TKOH
Introduction :
Free-text entry would be used for prescription of medications that were not available at GOPCs. However, the free-text drug items would bypass the allergy, drug-drug interaction and therapeutic duplication checking by the MOE system and might result in serious medication incidents. A medication safety enhancement exercise was therefore implemented at TKOH GOPCs by releasing the hospital drug item codes of commonly used chronic medications in the MOE.
Objectives :
1. To allow record keeping of non-GOPC medications prescribed by other specialities in the MOE during follow-up of chronic patients at GOPCs so as to minimize the risk of therapeutic duplication by different specialities or wrong regimen after medication adjustment.
2. To facilitate the prescription of non-GOPC medications as self-financed items (SFI) at GOPCs so as to minimize medication incidents on wrong dosage, drug allergy and drug-drug interaction.
Methodology :
342 chronic adult hospital drug items were selected with the drug item codes released in phases at 3 TKOH GOPCs since April 2019. The exercise was promulgated at Department and clinic meetings. Regular review was conducted and reminders for doctors were entered at Clinical Management System if free-text entry of medications with hospital drug item codes released were reported. The utilization on the released hospital drug item codes from 1st April 2019 to 30th November 2019 was reviewed.
Result & Outcome :
494 hospital drug item codes involving 332 patients were utilized during the review period. 370 (74.9%) and 124 (25.1%) hospital drug items were used as “keep record” and SFI prescriptions respectively. The top 5 hospital drug item codes being utilized were Clopidogrel (19.8%), Bisoprolol (9.5%), Tamsulosin (5.3%), Ezetimibe (3.4%) and Telmisartan (3.2%). Item codes of drug classes which were commonly involved in therapeutic duplication such as alpha-blocker (6.7%) and proton pump inhibitors (3.4%) were being used. Hospital drug item codes of other high risk medications like Warfarin (2.0%) and Ticagrelor (1.6%) were also utilized. Conclusion: The release of hospital drug item codes at GOPCs could facilitate medication prescriptions at GOPCs and enhance medication safety in both primary and secondary care.
