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Medication errors in Community Pharmacy: Potencial Causes and strategies for Prevention
Poster Presentations the Danish nationwide registers. The most common drugs leading to hospital admission will be identified and nationwide estimated rates of hospitalization will be calculated, adjusted for regional confounders. The study has been approved by the Danish Data Protection Agency (Id BBH-2015-005). Conclusions: The present study will yield an updated estimate of the rate of ADRs leading to hospital admissions and valuable information on high risk drugs and high risk patient characteristics. Furthermore, it will identify the frequency of ADRs leading to hospitalization in a post-marketing setting.
Is devolution of prescriptions contributing to community Pharmacies’ Financial crisis? J. Lopes1; C. Monteiro1; J. Joaquim1; and M. Rocha2 1 Instituto Politécnico de Coimbra, Coimbra Health School – ESTESC, Farmácia, Coimbra, Portugal; and 2Instituto Politécnico de Coimbra, Coimbra Health School – ESTESC, Ciências Complementares, Coimbra, Portugal Introduction: Portuguese community pharmacies were already affected by the global economic crisis. Pharmacies have experienced successive legislative amendments, including: the implementation of International Non-Proprietary Name (INN) prescription, the introduction of the National Code for the Electronic Prescription of Medicines (NCEPM) and the use of technical justifications by physicians. Devolution of prescriptions containing errors, by the Conference Center of Bills (CCB), represents an additional obstacle to the financial management of pharmacies. The aim of the study was to evaluate the economic impact caused by the devolution of prescriptions to pharmacies and to assess how the referred measures affected the drug dispensing process. Methodology: A longitudinal descriptive-correlational study was performed, based on a self-administered questionnaire delivered to each of the fifty pharmacies of Coimbra municipality. Software: SPSS 20.0®. Statistical tests: Friedman, Spearman’s Rho, Wilcoxon and Mann-Whitney U (significance level = 0.05). Results: The response rate was 58%. In September, the maximum value not paid to pharmacies was € 1,202.37. Statistically significant differences detected between the months analyzed showed a bigger impact of devolutions in September (maximum = 4.36%), mainly due to technical justifications, but also to implementation of NCEPM. In March, there was a reduction of the value not paid by CCB (maximum = € 603.09). After correction and resend of returned prescriptions, maximum impact was 0.8%. Patient’s health was not affected by the errors. Conclusions: INN prescription contributed to the reduction of returned prescriptions. Due to recent implementation, NCEPM contributed to increase devolutions. Technical justifications created difficulties in drugs dispensing process and actively contributed to increase the number of returned prescriptions. Values not paid by CCB have a significant impact on financial management of pharmacies. However, pharmacies can recover the majority of this value, after correction and resend of prescriptions. Electronic prescribing could be an effective measure, regarding the reduction of this impact.
Medication errors in Community Pharmacy: Potencial Causes and strategies for Prevention J. Lopes; J. Joaquim; C. Matos; and T. Pires Instituto Politécnico de Coimbra, Coimbra Health School – ESTESC, Farmácia, Coimbra, Portugal
August 2015
Introduction: Medication errors are serious safety concerns that have existed for as long as medications have been available to patients. They are a widespread problem, a major cause of adverse drug events and one of the most preventable causes of patient injury. The aim of this study was to investigate pharmacy professionals’ perception and opinions about potential causes of dispensing errors and the strategies to prevent them in community pharmacies. Material and Methods: Through a cross-sectional and descriptivecorrelational study, a survey was handed to all pharmacists and pharmacy technicians working in one of the 49 community pharmacies of a central Portuguese region. Results: The response rate was 90.9%. “Prescription” category assembled the largest number of causes of medication errors (26%). “Drugs” category was second with 23% of causes of errors. “Handwriting prescriptions” appear as the most frequent single cause of medication errors (51.5%). Besides this “source of errors”, the most frequent cause was “Patient in a hurry” (47.3%); “Outdated prescriptions” (46.4%) and “Drugs with similar packages” (45.6%). “Prescription” category assembled the largest number of preventive methods (34%). “Professional” category was second with 28%. The single prevention methods that generated the highest percentage of agreement were “Check of dubious prescriptions” and “Confirmation of the respective drugs through the barcodes” (97%). Besides these two preventive factors, “Constant updating and searching for knowledge” (96.5%), “Increased communication with the medical class” (95.9%) and “Electronic prescribing” (95.3%) yielded the highest agreement rate. Conclusions: Community pharmacy professionals identified some sources of medication errors, as well as some strategies to prevent them. Pharmacists and pharmacy technicians are key players in reducing the number of medication errors and in the consequent increase of patients’ safety. An appropriate educational intervention based on the findings of this study could improve the risk perception among pharmacy professionals.
Autoantibody presentation in Drug-Induced Liver Injury (DILI) and idiopathic Autoimmune Hepatitis (AIH): The influence of HLA alleles C. Stephens1; A. Ortega-Alonso1; I. Medina-Cáliz1; M. Robles-Díaz1; A. Castiella2; P. Otazua3; E. Zapata2; E.M. Gomez-Moreno4; M.A. López-Nevot4; F. Ruiz-Cabello4; G. Soriano5; E. Roman5,6; H. Hallal7; R.J. Andrade1; and M.I. Lucena1 1 Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain; 2Hosptial Mendaro, Guipúzcoa, Spain; 3Hospital Mondragon, Guipúzcoa, Spain; 4 Instituto de Investigación Biosanitario de Granada, Hospital Universitario Virgen de las Nieves, Universidad de Granada, Granada, Spain; 5Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, CIBERedh, Barcelona, Spain; 6Escola Universitària d’Infermeria EUI-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; and 7Hospital Morales Meseguer, Murcia, Spain Background: Positive autoantibody (AAB) titres are seen in a proportion of DILI patients, resembling AIH. The underlying mechanism for selective AAB occurrence in DILI is unknown, but could be associated with variations in immune-associated genes. Hence, we aimed to analyse HLA allele compositions in DILI with positive (AAB+) and negative (AAB-) AAB titres and AIH patients. Material and Methods: High resolution genotyping of HLA class I (A, B, C) and II (DRB1, DQB1) loci were performed on 178 DILI
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Is devolution of prescriptions contributing to community Pharmacies’ Financial crisis? J. Lopes1; C. Monteiro1; J. Joaquim1; and M. Rocha2 1 Instituto Politécnico de Coimbra, Coimbra Health School – ESTESC, Farmácia, Coimbra, Portugal; and 2Instituto Politécnico de Coimbra, Coimbra Health School – ESTESC, Ciências Complementares, Coimbra, Portugal Introduction: Portuguese community pharmacies were already affected by the global economic crisis. Pharmacies have experienced successive legislative amendments, including: the implementation of International Non-Proprietary Name (INN) prescription, the introduction of the National Code for the Electronic Prescription of Medicines (NCEPM) and the use of technical justifications by physicians. Devolution of prescriptions containing errors, by the Conference Center of Bills (CCB), represents an additional obstacle to the financial management of pharmacies. The aim of the study was to evaluate the economic impact caused by the devolution of prescriptions to pharmacies and to assess how the referred measures affected the drug dispensing process. Methodology: A longitudinal descriptive-correlational study was performed, based on a self-administered questionnaire delivered to each of the fifty pharmacies of Coimbra municipality. Software: SPSS 20.0®. Statistical tests: Friedman, Spearman’s Rho, Wilcoxon and Mann-Whitney U (significance level = 0.05). Results: The response rate was 58%. In September, the maximum value not paid to pharmacies was € 1,202.37. Statistically significant differences detected between the months analyzed showed a bigger impact of devolutions in September (maximum = 4.36%), mainly due to technical justifications, but also to implementation of NCEPM. In March, there was a reduction of the value not paid by CCB (maximum = € 603.09). After correction and resend of returned prescriptions, maximum impact was 0.8%. Patient’s health was not affected by the errors. Conclusions: INN prescription contributed to the reduction of returned prescriptions. Due to recent implementation, NCEPM contributed to increase devolutions. Technical justifications created difficulties in drugs dispensing process and actively contributed to increase the number of returned prescriptions. Values not paid by CCB have a significant impact on financial management of pharmacies. However, pharmacies can recover the majority of this value, after correction and resend of prescriptions. Electronic prescribing could be an effective measure, regarding the reduction of this impact.
Medication errors in Community Pharmacy: Potencial Causes and strategies for Prevention J. Lopes; J. Joaquim; C. Matos; and T. Pires Instituto Politécnico de Coimbra, Coimbra Health School – ESTESC, Farmácia, Coimbra, Portugal
August 2015
Introduction: Medication errors are serious safety concerns that have existed for as long as medications have been available to patients. They are a widespread problem, a major cause of adverse drug events and one of the most preventable causes of patient injury. The aim of this study was to investigate pharmacy professionals’ perception and opinions about potential causes of dispensing errors and the strategies to prevent them in community pharmacies. Material and Methods: Through a cross-sectional and descriptivecorrelational study, a survey was handed to all pharmacists and pharmacy technicians working in one of the 49 community pharmacies of a central Portuguese region. Results: The response rate was 90.9%. “Prescription” category assembled the largest number of causes of medication errors (26%). “Drugs” category was second with 23% of causes of errors. “Handwriting prescriptions” appear as the most frequent single cause of medication errors (51.5%). Besides this “source of errors”, the most frequent cause was “Patient in a hurry” (47.3%); “Outdated prescriptions” (46.4%) and “Drugs with similar packages” (45.6%). “Prescription” category assembled the largest number of preventive methods (34%). “Professional” category was second with 28%. The single prevention methods that generated the highest percentage of agreement were “Check of dubious prescriptions” and “Confirmation of the respective drugs through the barcodes” (97%). Besides these two preventive factors, “Constant updating and searching for knowledge” (96.5%), “Increased communication with the medical class” (95.9%) and “Electronic prescribing” (95.3%) yielded the highest agreement rate. Conclusions: Community pharmacy professionals identified some sources of medication errors, as well as some strategies to prevent them. Pharmacists and pharmacy technicians are key players in reducing the number of medication errors and in the consequent increase of patients’ safety. An appropriate educational intervention based on the findings of this study could improve the risk perception among pharmacy professionals.
Autoantibody presentation in Drug-Induced Liver Injury (DILI) and idiopathic Autoimmune Hepatitis (AIH): The influence of HLA alleles C. Stephens1; A. Ortega-Alonso1; I. Medina-Cáliz1; M. Robles-Díaz1; A. Castiella2; P. Otazua3; E. Zapata2; E.M. Gomez-Moreno4; M.A. López-Nevot4; F. Ruiz-Cabello4; G. Soriano5; E. Roman5,6; H. Hallal7; R.J. Andrade1; and M.I. Lucena1 1 Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain; 2Hosptial Mendaro, Guipúzcoa, Spain; 3Hospital Mondragon, Guipúzcoa, Spain; 4 Instituto de Investigación Biosanitario de Granada, Hospital Universitario Virgen de las Nieves, Universidad de Granada, Granada, Spain; 5Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, CIBERedh, Barcelona, Spain; 6Escola Universitària d’Infermeria EUI-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; and 7Hospital Morales Meseguer, Murcia, Spain Background: Positive autoantibody (AAB) titres are seen in a proportion of DILI patients, resembling AIH. The underlying mechanism for selective AAB occurrence in DILI is unknown, but could be associated with variations in immune-associated genes. Hence, we aimed to analyse HLA allele compositions in DILI with positive (AAB+) and negative (AAB-) AAB titres and AIH patients. Material and Methods: High resolution genotyping of HLA class I (A, B, C) and II (DRB1, DQB1) loci were performed on 178 DILI
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