title: [Formal prescribing errors are substantially reduced in electronic prescribing and after teaching sessions].
abstract: BACKGROUND
  Prescription forms enable the communication between physicians and pharmacists. Hence, incorrectly issued prescriptions may result in delay of health-care delivery, additional workload, and potentially adverse patient outcomes. We aimed to evaluate the formal prescription quality in our outpatient clinics (OC) before and after performing teaching sessions and using an electronic prescription system to replace handwritten prescriptions.
  
  
  METHODS
  All OCs of a university hospital were offered a short teaching session on how to issue prescriptions correctly and how to use the electronic prescription system. During four weeks before and after the teaching, we anonymously collected all prescriptions of the OCs in 20 surrounding community pharmacies and assessed whether they were error-free, required an intervention by the pharmacist, additional clarification by the OC, or had to be reissued.
  
  
  RESULTS
  After the intervention, the absolute fraction of formally error-free prescriptions increased by 12.9% from 52.9% (516/976) to 65.8% (713/1084, p < 0.001; d = 12,9% 95% confidence interval [8,7%; 17,1%]). Largest improvements were seen in prescriptions requiring clarification by the OC (224/976 prescriptions at baseline versus 93/1084 post-intervention, p < 0.001). The fraction of electronic prescriptions increased from 34.9% (341/976) to 46.9% (509/1084, p < 0.001, d = 12,0% 95% confidence interval [7,8%; 16,2%]) with electronic prescriptions consistently being of higher formal quality than handwritten prescriptions.
  
  
  CONCLUSIONS
  After increased use of electronic prescribing and teaching courses, formal prescription quality was significantly improved.
authors.affiliation: Abteilung Klinische Pharmakologie und Pharmakoepidemiologie, Universität Heidelberg.
authors.forename: H M
authors.initials: HM
authors.lastname: Seidling
authors.affiliation: Abteilung Klinische Pharmakologie und Pharmakoepidemiologie, Universität Heidelberg.
authors.forename: C K
authors.initials: CK
authors.lastname: Faller
authors.affiliation: Qualitätsmanagement / Medizincontrolling, Universitätsklinikum Heidelberg.
authors.forename: M
authors.initials: M
authors.lastname: Thalheimer
authors.affiliation: Institut für Medizinische Biometrie und Informatik Universität Heidelberg.
authors.forename: T
authors.initials: T
authors.lastname: Bruckner
authors.affiliation: Abteilung Klinische Pharmakologie und Pharmakoepidemiologie, Universität Heidelberg.
authors.forename: W E
authors.initials: WE
authors.lastname: Haefeli
mesh_terms: D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004502:Education, Medical, Continuing / Q000706:statistics & numerical data*; D055695:Electronic Prescribing / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data*; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data*; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data