Pharmacists’ Interventions on Electronic Prescriptions from Various Specialty Wards in a Malaysian Public Hospital: A Cross-Sectional Study

Abstract

Background: The emergence of new technologies in the area of health information and communication helps pharmacists to check the safety of medications used via electronic prescribing. Objectives: The study aimed to identify the rate and types of problems with electronic prescriptions (e-prescriptions) that required pharmacist intervention at an inpatient pharmacy, and to evaluate prescribers’ acceptance of these interventions. Methods: A retrospective cross-sectional study on the interventions of e-prescriptions documented by pharmacists was conducted in a public hospital inpatient pharmacy. Data were collected for descriptive analysis using a collection form, including the e-prescription interventions, types of wards, drugs involved, and acceptance of intervention by prescribers. A chi-square test was used to evaluate the association between ward pharmacist availability and the rate of interventions. Results: A total number of 11,922 (3.3%) pharmacist interventions were proposed for 357,760 e-prescriptions ordered in the 12 month study period. Of the total number of proposed interventions, 11,381 (95.5%) were accepted by prescribers. The interventions on e-prescriptions were from surgical wards (11.7%) followed by intensive care (5.6%), paediatric (3.5%) and medical specialty wards (2.9%). Anti-infective agents (33.8%) and cardiovascular medicines (27.0%) were among the drugs with the highest rate of interventions. The most common type of intervention was revising the drug regimen (58.4%), especially with anti-infective agents (33.8%). Prescribers in surgical wards showed the highest level of acceptance of pharmacist interventions, which was 97.37%. The presence of ward pharmacists showed a higher number of interventions (6.2 vs. 1.0%, p < 0.001) than wards without pharmacists, as well as a higher percentage of acceptance (96.4 vs. 91.1%, p < 0.001) towards e-prescription intervention. Conclusion: In e-prescribing, errors can be prevented by pharmacists’ interventions on e-prescriptions. This helps to prevent medication errors and thus optimise rational pharmacotherapy in patients. The role of ward pharmacists in pharmaceutical care is highly accepted by prescribers.