SIGNIFICANT NUMBERS of errors are being made by GPs when renewing prescriptions given to medical card patients on their discharge from hospital, a new study has found.
Under current regulations community pharmacists can only dispense up to one week’s supply of drugs to medical card patients when they present a prescription given to them by a hospital.
After that period of time the medical card patient, if they need further supplies of the medication recommended in their hospital prescription, must have the prescription reissued by their own GP.
Dublin-based pharmacist Bernard Duggan has studied the prescriptions issued by hospitals to individual patients and compared them with those subsequently obtained by the same patients when they asked their GPs to renew them. They were all presented for dispensing at one north Dublin pharmacy over a six-month period between September 2006 and February 2007 and this allowed the comparisons to be made.
He found some 27 per cent of items on the prescriptions which had been reissued by GPs were incorrect.
Mr Duggan, who conducted the research as part of a master’s degree programme, said the discrepancies had been checked with GPs as they were found, so patients were in fact ultimately dispensed the correct medication. This checking process, he said, was also able to allow the pharmacist determine if mistakes had been made by GPs, or if they had intentionally changed the items on patients’ prescriptions.
In all, 121 items or 27 per cent of the total number of items on transcribed prescriptions were incorrect as a result of mistakes made by family doctors.
“The most common error was the incorrect dose being prescribed on transcription, followed by a new therapy which was commenced in hospital not being continued by the GP. In 10 cases, the wrong medicine was prescribed on transcription,” Mr Duggan said.
One hospital discharge prescription, for example, said a patient was to have 150mg daily of a particular drug for inflammatory bowel disease. The GP’s repeat prescription indicated the patient was to take the 150mg three times daily. The pharmacy, having kept a record of the earlier hospital prescription, noted the discrepancy when presented with the second prescription from the GP.
The GP was contacted and the dose was adjusted. The incorrect dosage on the GP’s prescription could have caused bone marrow suppression, leading to increased risk of severe systemic infections.
Mr Duggan said the area of medication at the hospital/community interface had been identified internationally as an area where errors were likely to occur and this research indicated the situation in Ireland was no different.
The area needs to be looked at in terms of improving patient safety, and community pharmacists had a key role here, he added. Furthermore, he said the study showed how community pharmacists were having a positive impact on the health of patients.