title: Fertility patients and their prescriptions: a two-year audit of patient-pharmacist interactions in a reproductive endocrinology practice.
abstract: BACKGROUND
  This study assessed pharmacy performance and satisfaction as reported by patients during ovulation induction therapy.
  
  
  METHODS
  Patients (n = 1269) receiving gonadotropin prescriptions for intrauterine insemination or in vitro fertilisation-embryo transfer in 2007-2008 were prospectively interviewed by nurses and/or completed a structured questionnaire to evaluate pharmacy performance. "Community" (n = 12) and "specialty" (n = 2) pharmacy status (C vs. S) was defined by each pharmacy, and all pharmacies were selected by patients before cycle start. Patient comments about their pharmacy were classified into five types: i) Dispensing error-gonadotropin, ii) Dispensing error-non gonadotropin, iii) Mistake in prescribed medical equipment/supplies, iv) Counselling/communication inaccuracy, and v) Inventory problem or other.
  
  
  RESULTS
  391 pharmacy concerns were reported from 150 fertility patients during the study period. The majority (75.9%) of patients selected a S pharmacy to fill their prescriptions, and this pharmacy type was identified in 2.8% of adverse pharmacy encounters (p < 0.0001). Non-gonadotropin prescriptions filled at C pharmacies accounted for 40.2% of all complaints, followed by problems with prescriptions for supplies (20.2%) and gonadotropins (18.7%) at C pharmacies. Patient conflict involving S pharmacies was limited (n = 11), and related to operating hours and medication delivery logistics.
  
  
  CONCLUSIONS
  Fertility patients reported a disproportionate and significantly higher number of adverse pharmacy encounters from C pharmacies compared to S pharmacies. Although no licensing mechanism in Ireland currently recognises special training or certification in any area of pharmacy practice, informal self-designations by pharmacies remain a useful discriminator. Level of familiarity with fertility medicines and availability of inventory are important characteristics to be considered when counselling fertility patients about pharmacy choice. Those who select a C pharmacy should be advised to allow extra time for inventory verification, order confirmation, and additional counselling. Additional study is needed to determine if a minimum volume of fertility-related prescriptions is necessary to assure competence in this particular field of pharmacy practice.
authors: The Sims Institute and Sims International Fertility Clinic, Dublin, Ireland. drscottsills@sims.ie
authors: Eric Scott
authors: ES
authors: Sills
authors: Serhiy A
authors: SA
authors: Shurpyak
authors: Deirdre J
authors: DJ
authors: Gorman
authors: Lyuda V
authors: LV
authors: Shkrobot
authors: Grainne U
authors: GU
authors: Murray
authors: Beppi Mg
authors: BM
authors: O'Connor
authors: Una E
authors: UE
authors: Rapple
authors: Alicia O
authors: AO
authors: Fogarty
authors: Pavlina
authors: P
authors: Sarkova
authors: Kathy M
authors: KM
authors: Brickell
authors: David J
authors: DJ
authors: Walsh