[Most frequent drug-related events detected by pharmacists during prescription analysis in a university hospital].
OBJECTIVE
In France, the analysis of the prescriptions by a pharmacist in hospital is mandatory since 1991. However, for various reasons, this activity remained poorly developed and little research has been performed. Consequently, this activity suffers of a lack of visibility to hospital decision-makers and others health care professionals. The aim of this paper is to describe drugs related problems identified by pharmacist prescriptions analysis on a large number of orders in a large teaching hospital. This was done in order to highlight recurrent and preventable problems.


METHODS
During 1 year period, drug related problems detected by pharmacists when performing prescription analysis were registered prospectively.


RESULTS
Among 70,849 orders, 7073 drug related problems were registered. Most frequently detected drug related problems were: over dosages, especially with three drugs (zopiclone, zolpidem and acetaminophen) representing more than 10% of the pharmacist's interventions; optimization of drug administration especially with tablets that should not be crushed and intravenous to oral step-down therapy (7.5%); lack of conformity with consensus recommendations and contra-indications (12.8%); drug-drug interactions (11.6%) with a high proportion of absorption inhibition of one drug by another along the digestive tract; problems related to computerized physicians order entry (5.1%) appeared as an emerging phenomenon.


CONCLUSIONS
These results should be used to reexamine hospital drug prescription policy. They prompt health care professionals to be aware about new medications errors potentially related to computerized prescription order entry. Finally, they invite to modify initial and continuous education programs of health care professionals.
Arques-Armoiry
E
E
Service de pharmacie, groupement hospitalier de gériatrie, hôpital A.-Charial, hospices civils de Lyon, 40, avenue de la Table-de-Pierre, 69340 Francheville, France.
Cabelguenne
D
D
Stamm
C
C
Janoly-Dumenil
A
A
Grosset-Grange
I
I
Vantard
N
N
Maire
P
P
Charpiat
B
B
D004333:Drug Administration Routes; D004347:Drug Interactions; D062787:Drug Overdose; D011307:Drug Prescriptions / Q000592:standards* / Q000706:statistics & numerical data; D055695:Electronic Prescribing / Q000592:standards* / Q000706:statistics & numerical data; D005602:France; D019983:Guideline Adherence; D006784:Hospitals, Teaching; D006801:Humans; D007400:Interprofessional Relations; D050316:Medical Order Entry Systems / Q000592:standards* / Q000706:statistics & numerical data; D008508:Medication Errors / Q000145:classification / Q000517:prevention & control*; D010348:Patient Care Team; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000592:standards; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D013997:Time Factors