Authors (including presenting author) :
Chan KW(1)
Affiliation :
(1)Pharmacy Department, North District Hospital
Introduction :
Pharmacy is processing hundreds of outpatient prescriptions every day and identification of therapeutic duplication is one of the biggest challenge in checking the therapeutic appropriateness of the prescriptions. Occasionally, physician may unintentionally prescribe 2 drugs within the same therapeutic class and it can be difficult to spot such errors on the prescription manually. Such therapeutic duplication can result in adverse drug reactions which leads to unacceptable clinical outcome. At the time, there is no computerized checking system of therapeutic duplication.
Objectives :
This improvement project aims to: 1. Identify therapeutic duplication within a prescription and prevent related medication errors 2. Enhance the efficiency of performing such duplicate checking by using computerised system.
Methodology :
The dispensing data of the outpatient prescription of the day before will be retrieved everyday by using the system “PMS Query Template”. The data will include all the processed prescription data, e.g. patient’s ticket number, dispensing items, etc. The data will then be input in a programmed excel spreadsheet where automatic therapeutic duplication will be checked for every prescription that has been dispensed the day before for selected therapeutic class, e.g. antidiabetic and betablocker, etc. The programmed excel spreadsheet will then generate a report which contains information of the prescription where therapeutic duplication occurs. Such report will then be reviewed by pharmacist to evaluate whether the duplication is intended or unintended. If the duplication is unintended, physicians will be contacted for discussion or rectification, if any.
Result & Outcome :
After a year of implementation, there are 5 cases need to be further discussed with doctors and rectification is needed including 3 cases of DPP4 inhibitors, 1 case of betablocker and 1 case of duplication of prescribed and SFI Crestor. For example, a prescription with Alogliptin and vildagliptin are spotted in one case and prescribing physician is contacted and “Discontinue” function is used to discontinue the vildagliptin in patient drug profile. Patient is also contacted to stop the use of vildagliptin also.
