title: Differences in medication errors between central and remote site telepharmacies.
abstract: OBJECTIVE
  To examine differences in dispensing errors within community telepharmacy practices by comparing error rates across central sites (community telepharmacy sites with pharmacists present) and the corresponding remote sites, which are staffed by registered technicians and overseen by the central site pharmacist.
  
  
  METHODS
  Cross-sectional pilot study with a test group (remote sites) and comparison group (central sites).
  
  
  METHODS
  24 rural community telepharmacies (14 remote sites and 10 central sites).
  
  
  METHODS
  Pharmacy staff.
  
  
  METHODS
  The Pharmacy Quality Commitment (PQC) reporting system was integrated into the North Dakota Telepharmacy Project and used to track dispensing errors over a 45-month period. Both pharmacists and pharmacy technicians were trained on the use of the PQC system. The PQC system focused on two quality-related events (QREs): a "near miss" (i.e., a mistake discovered by the pharmacy staff before a medication reaches the patient) and an "error" (i.e., a mistake discovered after the patient leaves the pharmacy with the medication).
  
  
  METHODS
  The distribution of QREs across central and remote sites.
  
  
  RESULTS
  The remote (central) telepharmacy group reported 47,078 (62,480) prescriptions and a QRE rate of 1.34% (1.43%). QREs at the remote sites were more likely than at the central sites to be caught at the final pharmacist check (58.2% vs. 40.8%, P < 0.01) and less likely to be caught by the patient (0.17% vs. 0.28%, P < 0.01). Remote sites were more likely to include incorrect directions (18.9% vs. 13.4%, P = 0.01) in the medication entry process.
  
  
  CONCLUSIONS
  QRE rates for remote site and central site telepharmacies were consistent with each other and with national estimates in traditional community pharmacies. However, significant differences between central and remote sites existed based on how QREs arose and how they were caught. Pharmacists must recognize this fact and use diligence when working in a telepharmacy setting.
authors.affiliation: College of Pharmacy, North Dakota State University, Fargo, ND 58108-6050, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Scott
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Friesner
authors.forename: Ann M
authors.initials: AM
authors.lastname: Rathke
authors.forename: Charles D
authors.initials: CD
authors.lastname: Peterson
authors.forename: Howard C
authors.initials: HC
authors.lastname: Anderson
mesh_terms: D003157:Community Pharmacy Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D006801:Humans; D008508:Medication Errors / Q000145:classification / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011787:Quality of Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D017216:Telemedicine / Q000458:organization & administration / Q000706:statistics & numerical data*