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PubMed1999

Prudent use of antibacterial drugs in Norwegian aquaculture? Surveillance by the use of prescription data.

Antibacterial drug treatment in aquaculture during 1991-1996 was investigated using prescription data provided by the Norwegian Government Fish Inspection and Quality Control Service (NFCS). The majority of prescriptions (n = 5401) were for Atlantic salmon and rainbow trout (salmonids), while 383 prescriptions were for other species. Of the 13 different single substances or combinations prescribed during the study period, only 5 were approved for or had been subjected to clinical trials in salmonids. Of the prescriptions for the salmonids, 99% were for approved drugs or drugs subjected to clinical trials. The major proportion of the antibacterial drugs prescribed for other fish species were drugs which were approved for or which had been subjected to clinical trials in salmonids. In all fish species, the prescribing of antibacterial drugs which were neither approved for nor had been subjected to clinical trials was mainly for fish far below slaughter weight. The prescription data were validated against the drug statistics from the wholesalers and feed mills. It was concluded that the data indeed represented antibacterial drug prescribing in Norwegian aquaculture. The prescribing of antibacterial drugs proved to be almost completely reported to NFCS, which is responsible for the control of drug residues in farmed fish in Norway.

Animals↗
PubMed1999

Disparities in prescription drug insurance coverage.

OBJECTIVES: This article examines socioeconomic differences in supplementary insurance for prescription drugs among Canadians aged 15 or older and how the availability of such insurance affects prescription drug use. DATA SOURCE: The data on prescription drug insurance coverage and drug use are from the cross-sectional Health file of the 1996/97 National Population Health Survey (NPHS) conducted by Statistics Canada. The sample size of the population aged 15 or older was 70,884. ANALYTICAL TECHNIQUES: Rates of insurance coverage for prescription drug services were calculated. All summary estimates were age-adjusted using the 1996/97 population of Canada (both sexes). MAIN RESULTS: Among people aged 15 or older, 61% were covered for prescription medications in 1996/97. Sixty-five percent of workers reported coverage, while those who were not working were less likely to have benefits (52%). Only 38% of lower income groups had insurance compared with 74% of the highest income group. Regardless of the number of chronic diseases individuals had, those with drug insurance were more likely to report taking medication.

Adolescent↗
PubMed2001

[Studies on the supercritical-CO2 fluid extraction of complex prescription Danshen-Jiangxiang].

This paper first reported the supercritical-CO2 fluid extraction of complex prescription Danshen-Jiangxiang. With the active constituents and yield of extracts as index, the each other effect of each drug and effect on total complex prescription in extraction were studied. And the effects of pressure and temperature were also studied. The results showed the effects were different in complex prescription extraction and single prescription. Active constituents can be extracted, but a obvious effect exist each other and effects together the yield of extract, extraction rate and content of active constituents of complex prescription extraction, which are concerned in extraction conditions. These study results have important reference on the modernization of traditional Chinese medicines.

Carbon Dioxide↗
PubMed2001

[Changes in the patterns of drug prescription for acute myocardial infarct. Comparison of 2 periods].

BACKGROUND: Pharmacotherapy of Chilean patients with acute myocardial infarction has been recorded in 37 hospitals since 1993. AIM: To compare pharmacotherapy for acute myocardial infarction in the period 1993 to 1995 with the period 1997-1998. PATIENTS AND METHODS: Drug prescription during hospital stay was recorded in 2957 patients admitted to Chilean hospitals with an acute myocardial infarction in the period 1993-1995 and compared with that of 1981 subjects admitted in the period 1997-1998. RESULTS: When compared with the former period, in the lapse 1997-1998 there was an increase in the frequency of prescription of aspirin (93 and 96.1% respectively) beta blockers (37 and 55.2% respectively) and angiotensin converting enzyme inhibitors (32 and 53%). The prescription of thrombolytic therapy did not change (33 and 33.7% respectively). There was a reduction in the prescription of calcium antagonists and antiarrhythmic drugs. CONCLUSIONS: During the period 1997-1998, the prescription of drugs with a potential to reduce the mortality of acute myocardial infarction, increased. The diffusion of guidelines for the management of this disease may have influenced this change.

Adrenergic beta-Antagonists↗
PubMed2001

Improving antibiotic and bronchodilator prescription in children presenting with difficult breathing: experience from an urban hospital in India.

OBJECTIVE: To evaluate the relative frequency of other conditions that share a clinical overlap with pneumonia as defined by the WHO case management algorithm and to determine the possibility of refining the antibiotic and bronchodilator prescription on the basis of simple clinical features. DESIGN: Prospective observational. SETTING: Urban tertiary care center. METHODS: Two hundred children, between the ages of 6 months to 5 years, presenting with difficult breathing (as defined by WHO algorithm) were prospectively evaluated for the diagnosis and the need for bronchodilator and antibiotic therapy (clinician s diagnosis). An additional independent blinded evaluation of the chest X-rays was done by a radiologist after the study (radiologist-aided diagnosis). On the basis of reliable predictors (sensitivity > 70% and specificity > 70%) of antibiotic and bronchodilator prescription, irrespective of the exact diagnostic category, two viable modifications of WHO case management algorithm emerged, which were compared by paired proportion test. RESULTS: Acute asthma was the predominant condition (46% or 54%), pneumonia alone was rare (10%), co-existence of pneumonia with wheeze (bronchospasm) was more frequent (22% or 15%) and often diagnoses not related to the respiratory system were documented (18% or 17%). All the subjects in whom a preceding history of cough was not elicited had non-respiratory illnesses. An audible wheeze was appreciated in only 44 of the 150 cases (29.3%) with an auscultable wheeze. The two alternatives represented a significant (p < 0.0001) improvement over the WHO algorithm preventing inappropriate usage of both antibiotics and bronchodilators, primarily by restricting over-prescription of the former (14% and 26.5% for proposed algorithms 1 and 2, respectively) and under-utilization of the latter (40%). The performance of the alternative algorithms for the radiologist-aided diagnosis was marginally better for over-prescription of antibiotics (16.2% and 30.9% for proposed algorithms 1 and 2, respectively). CONCLUSION: It is feasible to amalgamate simple clinical features (history of: (i) previous similar episode of cough and difficult breathing, and (ii) fever) in the WHO case management algorithm to significantly refine the antibiotic (95% CI range 7% to 33%) and bronchodilator (35%; 95% CI 27% to 43%) prescription.

Algorithms↗
PubMed2001

[Evaluation of changing antibiotic prescription habits in a general hospital center].

OBJECTIVE: Two audits of antibiotic prescriptions were conducted within the framework of the fight against bacterial resistance conducted at the Valence Hospital Center (Drôme, France). The first was made between July 1st and 31st 1998 and the second between December 15th 1999 and January 15th, 2000, both based on the prospective observation scheme. PATIENTS AND METHODS: We studied prescriptions written for antibiotics, recording the compound prescribed, the therapeutic indication, the type of infection and the prescriber. Results of these two audits were compared with the chi-square test. RESULTS: The prescriber was correctly identified (name + signature) on 63.1% of the prescriptions in 1998 and on 92.9% in 1999-2000. The patient was correctly identified (name + first name + age) in 89.9% of the prescriptions in 1998 compared with 95% in 1999-2000. For the compounds prescribed, 30.2% of the prescriptions were complete (name + dose + frequency + duration + administration route) in 1998 compared with 44.5% in 1999-2000. The antibiotic was prescribed for prophylactic purposes in 16.2% of the cases in 1998 and in 8.6% in 1999-2000. Empirical curative antibiotic therapy was prescribed in 44.7% of the cases in 1998 and in 49.3% in 1999-2000. Curative antibiotic therapy was prescribed in 16.2% in 1998 and in 9.3% in 1999-2000 for proven infection and with no mention of proof in 22.9% in 1998 and 32.8% in 2000. DISCUSSION: We observed an improvement in the identification of the prescriber, the patient and the drugs used between the two audits. These results were generally satisfactory and reflect the impact of an information campaign conducted after the first audit. Such audits are part of the ongoing policy designed around the antibiotic booklet and within the framework of the newly instituted antibiotic committees.

Anti-Bacterial Agents↗
PubMed2001

[Prophylactic prescription of low-molecular-weight heparin in the non-surgical setting: impact of recommendations].

OBJECTIVE: Low-molecular-weight heparins (LMWH) had official approval for use for venous thromboembolism prophylaxis only for surgery patients when this survey was conducted, but were nevertheless often used in non-surgery patients. We conducted this "before and after" survey from May 1998 to April 1999 to assess the impact of the recommendations implemented in the beginning of 1999. METHODS: Data on the use of LMWH were collected on three different days within a three week interval in all non-surgery departments at the Tenon hospital before distribution of expert recommendations early in 1999. Published in La Presse Médicale in January 2000, these recommendations issued from an external panel of 43 experts who were contacted to establish a consensus opinion using the Delphi method. Data were again collected on three different days after implementation of the recommendations. Implementation was based on a patient-specific prescription order form requested by the hospital pharmacy for delivery to the department. RESULTS: Data were collected for 121 prescriptions prior to the recommendations and for 158 after. Sex-ratio, mean age and percentage of LMWH prescriptions did not differ significantly between the two periods. There was a lower number of non-appropriate prescriptions after implementation of the recommendations from 54.5% to 35.4% (p = 0.01) with better conformity for recommendation A (high-risk patients) (36% versus 43%, NS) and for recommendation B (= 2 risk situations or = 1 risk situation and = 2 aggravating factors) (10% versus 22%, p = 0.01). Better conformity of LMWH prescriptions in oncology and radiotherapy departments partially explained this general improvement, but the difference remained significant when excluding these two departments (p = 0.04). CONCLUSION: This study shows that physician compliance with recognized expert recommendations can improve their implementation. This procedure is now in general use in the Tenon hospital.

Aged↗
PubMed2001

[Using chengqi prescription to prevent hepatic ischemia/reperfusion injury after liver transplantation in rats].

OBJECTIVE: To study the effect of Chengqi prescription in preventing hepatic ischemia/reperfusion injury after liver transplantation in rats. METHODS: Rat in situ liver transplantation model was used, donor liver was preserved in Ringer's solution for 4 hrs under 4 degrees C, then divided randomly into Chinese medicine group (Chengqi prescription), polymyxin B group, mannitol group, normal saline group and sham operation control group, each group further subdivided into two subgroups: 1 hr group and 4 hrs group after transplantation. The serum ALT and liver injury index was determined. RESULTS: In preventing hepatic ischemia/reperfusion injury after liver transplantation, the Chengqi prescription was polymyxin B showed more effective than that of mannitol and normal saline, and the effect of Chengqi prescription was higher than that of polymyxin B (P < 0.05). CONCLUSION: Chengqi prescription was effective in preventing hepatic ischemia/reperfusion injury after liver transplantation in rat.

Animals↗
PubMed2003

[Effects of Qiang Gu Kang Wei prescription on morphology of bone in rats under simulated weightlessness].

OBJECTIVE: To investigate effects of Qiang Gu Kang Wei prescription on bone morphology in tail-suspended rats. METHOD: Rats were tail-suspended (-30 degrees) for 21 d to simulate weightlessness. The effects of this prescription on thickness of periost and cortex at epiphyseal plate of tibial shaft and 3 mm under it were examined. The effects of this prescription on histology and ultrastructure of tibia were also observed. RESULT: Compared with the normal control, cortex at both epiphyseal plate of tibial shaft and 3 mm under it in suspended rats thinned significantly (P<0.01 or P<0.05). Histological observation showed that in bone of suspended rats, uncalcific matrix was more, bone cells' number was lower and their appearance was more infantile, osteoblasts were less and smaller, while osteoclasts were more and larger, haversian system of transection also showed more irregular than in bone of normal control. Ultrastructure observation showed that the function of osteoblasts was inhabited and that of osteoclasts was active. All the three doses groups of the prescription could increase cortex at either epiphyseal plate of tibial shaft or 3 mm under it (P<0.01 or P<0.05) compared with the tail-suspended group. The appearance of bone in the three groups was improved as well under optical or electron microscope. CONCLUSION: This prescription could improve abnormal change in bone morphology resulted from being tail-suspended in rats and make it normal.

Animals↗
PubMedDate not supplied

The variability of TCM pattern diagnosis and herbal prescription on rheumatoid arthritis patients.

CONTEXT: The consistency of diagnosis made among Traditional Chinese Medicine (TCM) practitioners and the relationship between TCM diagnosis and Chinese herbal prescription have not been adequately examined. OBJECTIVE: To investigate the degree of consistency with which TCM diagnoses and herbal prescriptions can be made by practitioners examining rheumatoid arthritis (RA) patients. To survey TCM diagnostic patterns and to examine the correlation between herbal prescriptions and these diagnoses for a sample of RA patients. DESIGN: A prospective survey. SETTING: General Clinical Research Center, University of Maryland Hospital System, Baltimore, MD. PATIENTS: Rheumatoid arthritis patients. PRACTITIONERS: Licensed acupuncturists with a minimum of 5 years licensure and education in Chinese herbs. METHODS: Three TCM practitioners examined the same 39 RA patients separately, following the traditional "Four Diagnostic Methods." Patients filled out a questionnaire to serve as the data for the "Inquiry" component. They then underwent a physical examination, including the tongue and pulse, conducted by each of the practitioners. Based upon the examination results, each practitioner provided both a TCM diagnosis and a herbal prescription. These diagnoses/prescriptions were then examined with respect to the rate of agreement among the 3 practitioners. RESULTS: The average agreement with respect to the TCM diagnoses among the 3 pairs of TCM practitioners was 28.2% (25.6 to 33.3% with kappas ranging from 0.23 to 0.30). The degree to which the herbal prescriptions agreed with textbook recommended practice of each TCM diagnosis was 93.2% (range = 87.2 to 100%). CONCLUSION: The total agreement on TCM diagnosis on RA patients among 3 TCM practitioners was low. When less stringent, but theoretically justifiable, criteria were employed, greater consensus was obtained among the 3 practitioners. The correspondence between the TCM diagnosis and the herbal formula prescribed for that diagnosis was high, although there was little agreement among the 3 practitioners with respect to the herbal formulas prescribed for individual patients.

Adult↗
PubMed2005

Medicaid prescription drug access restrictions: exploring the effect on patient persistence with hypertension medications.

OBJECTIVE: To compare rates of discontinuation of prescription therapy for hypertension in Medicaid patients with and without medication access restrictions. STUDY DESIGN: Retrospective cohort study. METHODS: Prescription data were extracted from a pharmacy claims database in a large state that implemented a Medicaid preferred drug list (PDL), both before and after the PDL was implemented. Prescriptions filled between June 2000 and May 2003 were included. RESULTS: Medicaid patients taking prescription medications commonly used to treat hypertension were 39% (odds ratio = 1.39; 95% confidence interval, 1.21, 1.6) more likely to discontinue hypertension therapy after the restriction was implemented compared with Medicaid patients 1 year earlier when there were no restrictions. Patients were classified as "discontinued" if they had therapy available less than 50% of the time during the 12 months after implementation of the PDL. Before the PDL, 17% of patients receiving treatment with hypertension medication discontinued therapy. After the PDL, 21% of Medicaid patients taking hypertension medication discontinued therapy. After the PDL, Medicaid patients were significantly more likely to switch medications from a restricted to an unrestricted drug. Those patients also were less likely to have a restricted drug added to their therapy regimen. CONCLUSIONS: After implementation of the PDL, Medicaid patients were more likely to discontinue filling prescriptions for antihypertensive medication. Because hypertension management is an important challenge within the Medicaid community, the potential connection between access restrictions and patient adherence to medication therapy is a worthy topic for further exploratory studies and quantitative outcomes research.

Adult↗
PubMed2005

Medicare program; Medicare prescription drug benefit; interpretation. Final rule; interpretation.

This final rule modifies or clarifies our interpretations in several areas of the final rule titled "Medicare Prescription Drug Benefit" published in the Federal Register on January 28, 2005. First, it clarifies our interpretation of "entity", to respond to inquiries we received subsequent to the publication of the Prescription Drug Benefit (Part D) final rule on January 28, 2005. We were asked whether a joint enterprise could be considered an "entity" under section 1860D-12(a)(1) of the Social Security Act (the Act), for purposes of offering a prescription drug plan (PDP). Our interpretation is discussed in the Supplementary Information section of this final rule. Second, also subsequent to the publication of the Prescription Drug Benefit (Part D) final rule on January 28, 2005, we received inquiries from parties about our discussion of the actuarial equivalence standard and the manner in which an employee health plan sponsor could apply the aggregate net value test in the regulatory text of the final rule. Our interpretation is discussed in the "Provisions" section of this final rule. In addition, subsequent to publishing the August 3, 2004 proposed rule (69 FR 46684), we received comments on how the late enrollment penalty would be coordinated with the late enrollment penalty for Part B, and whether the one percent penalty would be sufficient to control for adverse selection. We clarify in the Provisions section of this final rule that the example given in the proposed rule, published on August 3, 2004, did not accord with the proposed or final regulatory language because it did not account for the fact that the base beneficiary premium increases on an annual basis. To remedy this error and in response to comments received on the proposed rule, we provide an interpretation that as the base beneficiary premium increases, the late enrollment penalty must also increase, and is in keeping with how the Part B penalty is calculated. Finally, we are providing clarifying language related to transitioning Part D enrollees from their prior drug coverage to their new Part D plan coverage. The Medicare Prescription Drug Benefit final rule will take effect on March 22, 2005. Our interpretations are deemed to be included in that final rule.

Health Benefit Plans, Employee↗
PubMed2005

Evolution of the National All Schedules Prescription Electronic Reporting Act (NASPER): a public law for balancing treatment of pain and drug abuse and diversion.

In the United States, physicians are faced with two opposing dilemmas in the treatment of pain - the potential for drug abuse and diversion, and the possible undertreatment of pain. While controlled prescription drugs such as narcotic analgesics, anxiolytics, antidepressants, stimulants, and sedative-hypnotics, play a legitimate role in managing chronic pain and other conditions, the illicit use of prescribed medicines is increasing at epidemic proportions. Diversion and abuse of prescription drugs is costly in terms of addiction, overdose, death, and related criminal activities, but chronic pain carries significant economic, social, and health impact as well. The American Society of Interventional Pain Physicians (ASIPP), as the introducing organization, was joined by several physician and nurse practitioner organizations in support of the National All Schedules Prescription Electronic Reporting (NASPER) Act of 2005, legislation that not only will give physicians an information tool to aid in prescribing controlled substances but also will help identify illicit use and abuse. NASPER is the law that provides for the establishment of a controlled substances monitoring program in each state. The concept for NASPER originated with ASIPP and was modeled after the highly successful Kentucky All Schedules Prescription Electronic Reporting Program (KASPER). Legislation was introduced in the United States House of Representatives during three different Congresses, the 107th, 108th, and 109th, by Reps. Edward Whitfield (R-KY) and Frank Pallone (D-NJ). It was first introduced in the United States Senate in the 107th Congress by Sen. Tim Hutchinson (R-AK), and in the 108th and 109th by Sens. Jeff Sessions (R-AL) and Dick Durbin (D-IL), with multiple cosponsors in both chambers. NASPER passed the House on July 27, 2005, by voice vote and passed the Senate by unanimous consent on July 29, 2005. President George W. Bush signed NASPER on August 11, 2005, and it became Public Law 109-60. Implementation of NASPER will improve patient care and reduce abuse and diversion of prescription controlled substances.

Journal Article↗
PubMed1990

[Effect of yiqi-yangyin prescription on bile composition of cholelithiasis patients].

There were 41 postoperative patients of cholelithiasis with manifestation of Qi-Yin deficiency, had treated with Yiqi Yangyin Prescription. The regimens was 2 weeks as a course, thereafter bile specimens were taken through T tube drainage, and biochemical analysis were performed in order to determine the composition in consequence of the comparison of the treated patients with the control groups. There were 19 patients of bile pigment stone in whom 10 treated with the prescription and 9 were served as control. The results showed that the total bilirubin, unconjugated bilirubin, the concentration of calcium ion and the activity of beta-glucuronidase were markedly decreased as compared to those in the control group (P less than 0.05), the concentration of bile acid markedly increased than that in the control group (P less than 0.05). There were 22 patients of cholesterol stone, 11 treated with the prescription and 11 were served as control group. The results were the same as in bile pigment stone group except decreased in conjugated bilirubin (P less than 0.05), and the unconjugated bilirubin were remained unchanged (P greater than 0.05) as compared to the control group. The ratio of unconjugated bilirubin to total bilirubin and the ratio of bile acid to bilirubin were markedly decreased as compared to those in the control group. The above observation showed promptly that Yiqi-Yangyin Prescription gave a promise influence on lithogenic bile of cholelithiasitic patients, and also investigated the mechanism of the prescription used for deficiency patients with biliary troubles.

Adult↗
PubMed1989

[Prescription of tranquilizers and hypnotics in the municipality of Holbaek].

On the basis of an investigation of prescriptions of tranquillizers and hypnotics for individuals resident in the Municipality of Holbaek, a description was made of which tranquillizers and which hypnotics were prescribed and the quantities provided. 96% of the prescriptions were written by the general practitioners in the town. Only 2% of the patients had obtained medicine from various doctors. Benzodiazepine derivatives constituted 93% of all tranquilizers and 96% of the hypnotics prescribed. Diazepam, nitrazepam and triazolam were the preparations most frequently prescribed. Diazepam, flunitrazepam and the older hypnotics were prescribed in quantities which suggested that these preparations were preferred by chronic users with massive drug intake. The smallest portions available were employed for 17% of the prescriptions for tranquillizers and in 2% of the prescriptions for hypnotics. The favourite amount prescribed was 100 tablets. Where triazolam was concerned, strikingly high defined daily dosages were prescribed. As only brief or episodic use is rational, half of all the tranquilizers and four out of five prescriptions for hypnotics are considered unsuitable.

Aged↗
PubMedDate not supplied

The attitudes of consumers toward direct advertising of prescription drugs.

Attitudes about prescription drug advertising directed to consumers were assessed in 1,509 persons who had viewed prototypical advertisements for fictitious prescription drug products. Although many subjects were generally favorable toward the concept of drug advertising directed to consumers, strong reservations were also expressed, especially about television advertising. Prescription drug advertising did not appear to undermine the physician's authority, since respondents viewed the physician as the primary drug decision-maker. However, the physician was not perceived as the sole source of prescription drug information. Television advertising appeared to promote greater information-seeking about particular drugs; however, magazine ads were more fully accepted by subjects. Furthermore, magazine ads led to enhanced views of the patient's authority in drug decision-making. The greater information conveyed in magazine ads may have given subjects more confidence in their own ability to evaluate the drug and the ad. Ads that integrated risk information into the body of the advertisement were more positively viewed than ads that gave special emphasis to the risk information. The results suggest that consumer attitudes about prescription drug advertising are not firmly held and are capable of being influenced by the types of ads people view. Regulation of such ads may need to be flexed to adapt to the way different media are used and processed by consumers.

Adult↗
PubMed1995

Antiarrhythmic drug prescription in patients after myocardial infarction in the last decade. Experience of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (GISSI).

BACKGROUND: Recent clinical trials have shown increased, rather than decreased, mortality in patients treated with antiarrhythmic drugs after acute myocardial infarction. OBJECTIVE: To determine whether these findings had an impact on prescription of antiarrhythmic drugs after acute myocardial infarction. METHODS: We retrospectively analyzed the class I and III antiarrhythmic prescription data of 38,072 patients with acute myocardial infarction enrolled in three large randomized clinical trials endorsed by a highly representative sample (about 75%) of Italian coronary care units during the last 10 years. The first study was conducted in 1984 to 1985; the second, in 1988 to 1989; the pilot for the third, in 1991; and the third, in 1991 to 1994. RESULTS: Total class I and III antiarrhythmic prescriptions after acute myocardial infarction was halved during the last decade, from 11.9% at discharge and 14.4% at follow-up in 1984 to 1985 to 5.8% and 5.8%, respectively, in 1991 to 1994. The trend was independent of the different distributions in the three studies of the patients' characteristics associated with antiarrhythmic use (ie, age > or = 70 years, anterior acute myocardial infarction, ventricular fibrillation during hospitalization, and Killip class > or = 2 at randomization). The same decreasing trend was observed for each antiarrhythmic drug. The drug most widely used was amiodarone, accounting for about half of the antiarrhythmic prescriptions, followed by mexiletine hydrochloride and propafenone hydrochloride; flecainide acetate was dropped from the prescription list after the publication of the Cardiac Arrhythmia Suppression Trial results. CONCLUSION: The negative results of the recent clinical trials on class I antiarrhythmic drug use after acute myocardial infarction have been rapidly transferred into routine clinical practice in Italy, since the proportion of patients who received class I and III antiarrhythmic drugs after acute myocardial infarction was halved from the early 1980s to the early 1990s.

Aged↗
PubMed1993

[Detection of prescription errors in drug dispensing: incidence and typology].

OBJECTIVE: Description and quantification of the types of prescribing errors during dispensing activities at community pharmacies. DESIGN: Descriptive transversal study carry out along four weekly periods. SITE. Eighteen pharmacies from six of the spanish autonomous regions dispensing prescription orders mainly issued by the National Health Service. PATIENTS AND OTHER TAKING PART: 37,321 prescriptions of specialties dispensed by the mentioned pharmacies along the four week period. MAIN MEASUREMENTS AND RESULTS: An unstructured questionnary was applied to all persons asking for one of the mentioned prescriptions. When an error was suspected, a second structured questionnary was applied by the pharmacist to the order bearer and the answers plus the information contents at the prescription form was collected on a data-sheet. Data were processed on a dBase and SPSS programs. Incidence detected error of 1.35%. Types of error classified into five categories. Study of the variability of error detection by week and by pharmacy. Analysis and comparison with references of the "order author" data and "prescriptor" data. CONCLUSIONS: Our global incidence of detected error was lower in relation with other studies. We found short differences by weeks and large by pharmacies. Inadequate definition of the drug was the most frequent type of error. The detection frequency of posology error was higher following the use of the new prescription order model. The number of orders from different prescriptor/author was larger in our study in relation to the notified by other studies.

Medication Errors↗