Evaluation of e-prescribing in chain community pharmacy: best-practice recommendations.
OBJECTIVE
To measure the attitudes and beliefs of community-based pharmacists and technicians toward electronic prescribing (e-prescribing) and the processing of e-prescriptions and to generate best-practice recommendations for changes to improve e-prescribing in the community setting.


METHODS
Descriptive, nonexperimental, cross-sectional study.


METHODS
422 chain community pharmacies in six states that met a minimum dispensing volume of five e-prescriptions per day. Data were collected between April and July 2006.


METHODS
Pharmacists, technicians, and student interns.


METHODS
Receiving, processing, and dispensing of e-prescriptions assessed via self-administered survey and follow-up interviews of key pharmacy operations and information technology management in each participating chain pharmacy organization.


METHODS
Attitudes, beliefs, and satisfaction of pharmacy personnel regarding e-prescribing, compared with conventional prescribing, and recommendations for improving e-prescribing in the community practice setting.


RESULTS
1,094 surveys were returned from pharmacy personnel practicing in 276 chain community pharmacies. Pharmacy personnel preferred e-prescriptions over conventional prescriptions on each of seven desired outcomes of care. Pharmacists were found to view e-prescribing more positively than technicians (P < 0.05) for its net effect on three key outcomes: patient safety, effectiveness of care, and efficiency of care. A total of 2,235 written comments were received on the returned surveys. Of these, 57% (1,277) mentioned negative features of e-prescribing, while 43% (958) noted positive features. Improved clarity and/or legibility of prescriptions was the most frequently cited advantage of e-prescribing, followed closely by improved speed or efficiency of processing. Prescribing errors were the most commonly cited negative feature of e-prescribing, particularly those stating a wrong drug or wrong directions.


CONCLUSIONS
Pharmacy personnel were generally satisfied with the current status of e-prescribing, but they also perceive key weaknesses in how it has been implemented in physicians' practices and their own organizations. A total of 11 best-practice recommendations are offered to improve e-prescribing in the chain community pharmacy setting.
Rupp
Michael T
MT
College of Pharmacy, Midwestern University, Glendale, Ariz 85308, USA. mtrupp@midwestern.edu
Warholak
Terri L
TL
D001291:Attitude of Health Personnel; D003157:Community Pharmacy Services / Q000458:organization & administration; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000517:prevention & control; D010595:Pharmacists / Q000523:psychology*; D010596:Pharmacy Technicians / Q000523:psychology; D011785:Quality Assurance, Health Care / Q000379:methods; D014481:United States