Pharmacy communications with physician offices to clarify prescriptions.
OBJECTIVE
Our study was conducted to: (1) characterize the type and extent of prescription clarification communications between community pharmacies and physician offices, (2) describe the interventions made by community pharmacists, and (3) determine the time frame to clarify prescriptions prior to dispensing.


METHODS
A convenience sample and cross-sectional study.


METHODS
Five independent community pharmacies.


METHODS
Pharmacists and pharmacy technician staff members.


METHODS
Participating pharmacy staff members documented the type of interventions and length of time to resolve prescription clarifications.


METHODS
Number, type, and reason for pharmacist interventions to clarify prescriptions.


RESULTS
Prescriptions that required clarification with physicians' offices were mostly new (n = 105; 74%) compared with refill prescriptions (n = 36; 26%). Electronic prescriptions (n = 51; 36%) required clarification more often than other types of prescription transmission. New prescriptions transmitted by e-prescribing required pharmacy-physician office communications 4-fold more frequently than faxed prescriptions and nearly 2-fold more frequently than written prescriptions. The most frequent reasons for pharmacy communications with the physician office were prior authorization approval (n = 45; 32%) and missing prescription information (n = 22; 16%). The most frequent resolutions involved dispensing a different dosage strength (n = 19; 11%) and different drug (n = 17; 10%). At the end of the study period, 30 (17%) prescription clarification cases were unresolved; most of the unresolved cases involved prior authorizations. Person-to-person telephone contacts had an 80% resolution rate compared with a 55% resolution rate for fax communications (P <0.001). The time frame to clarify prescriptions ranged from 6 minutes to more than 14 days.


CONCLUSIONS
Person-to-person telephone contacts may be more efficient than fax communications for resolving prescription clarifications, especially for more complex information needs. This study lends to ongoing improvement efforts in e-prescribing interfaces with pharmacy information systems to reduce the burden of prescription clarification.
Marie
M
Smith
Bradley
B
Sprecher
D003157:Community Pharmacy Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000592:standards*; D055695:Electronic Prescribing; D006801:Humans; D033183:Interdisciplinary Communication; D008508:Medication Errors / Q000517:prevention & control; D010595:Pharmacists / Q000458:organization & administration / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000592:standards; D013997:Time Factors