Drug related problems identified by community pharmacists on hospital discharge prescriptions in New Zealand.
BACKGROUND
There can be a lack of transfer of information between hospitals and community pharmacies following patient discharge, which puts patients at a high risk of suffering drug related problems (DRPs). Community pharmacy plays a vital role in identifying and solving these discharge DRPs and taking action before these DRPs can lead to patient harm.


OBJECTIVE
To identify the types and quantities of DRPs that community pharmacies detect within a single district health board (DHB) in New Zealand.


METHODS
One DHB in New Zealand that contains 50 community pharmacies, which receive discharge prescriptions from two local hospitals.


METHODS
All community pharmacies in the DHB area (n = 50) were invited to participate in the 2 week study which involved documenting the number of hospital discharge prescriptions received, and then the number and type of DRPs identified and what interventions were required.


METHODS
The number and type of DRPs identified as a proportion of all discharge prescriptions received during the 2 week study period.


RESULTS
Initially a total of 38 pharmacies agreed to participate in this study, however only 32 pharmacies provided data for the entire 2 week period. Over a 2 week period a total of 1,374 hospital discharge prescriptions were presented to these pharmacies. From these prescriptions 344 (25 %) required further action to be taken by the pharmacist. These 344 prescriptions consisted of a total of 396 individual DRPs. Actions classified as "Supply and/or Funding" accounted for 43 % (171), which represented the largest class of all actions required from hospital discharge prescriptions. This class consisted of "Special Authority" problems, medications not being available, non-subsidised items on the prescription and other supply/funding problems. "Errors" accounted for 38 % (151) which included errors of omission (20 %) and errors of commission (18 %).


CONCLUSIONS
This study found a significant number of DRPs identified by community pharmacists on hospital discharge prescriptions. These included missing and incorrect information which required clarification with prescribers. Interventions need to be put in place to reduce the number of errors and improve clarity of hospital discharge prescriptions. Better information sharing and understanding of medications available in primary care will reduce the potential for DRPs.
School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand, Rhiannon.braund@otago.ac.nz.
Rhiannon
R
Braund
Carolyn V
CV
Coulter
Amy Jane
AJ
Bodington
Lauren Margaret
LM
Giles
Anna-Marie
AM
Greig
Larissa Jane
LJ
Heaslip
Brooke Jane
BJ
Marshall
D003157:Community Pharmacy Services / Q000706:statistics & numerical data*; D003266:Continuity of Patient Care; D006801:Humans; D008508:Medication Errors / Q000706:statistics & numerical data; D009520:New Zealand; D010351:Patient Discharge / Q000706:statistics & numerical data*; D055553:Prescription Drugs / Q000008:administration & dosage* / Q000191:economics / Q000600:supply & distribution; D024382:Professional Role; D013222:State Medicine
D055553:Prescription Drugs