Evaluation of e-prescribing in chain community pharmacy: best-practice recommendations.

摘要

OBJECTIVES: To measure the attitudes and beliefs of community-based pharmacists and technicians toward electronic prescribing (e-prescribing) and the processing of e-prescriptions and to generate best-practice recommendations for changes to improve e-prescribing in the community setting. DESIGN: Descriptive, nonexperimental, cross-sectional study. SETTING: 422 chain community pharmacies in six states that met a minimum dispensing volume of five e-prescriptions per day. Data were collected between April and July 2006. PARTICIPANTS: Pharmacists, technicians, and student interns. INTERVENTION: Receiving, processing, and dispensing of e-prescriptions assessed via self-administered survey and follow-up interviews of key pharmacy operations and information technology management in each participating chain pharmacy organization. MAIN OUTCOME MEASURES: Attitudes, beliefs, and satisfaction of pharmacy personnel regarding e-prescribing, compared with conventional prescribing, and recommendations for improving e-prescribing in the community practice setting. RESULTS: 1,094 surveys were returned from pharmacy personnel practicing in 276 chain community pharmacies. Pharmacy personnel preferred e-prescriptions over conventional prescriptions on each of seven desired outcomes of care. Pharmacists were found to view e-prescribing more positively than technicians (P < 0.05) for its net effect on three key outcomes: patient safety, effectiveness of care, and efficiency of care. A total of 2,235 written comments were received on the returned surveys. Of these, 57% (1,277) mentioned negative features of e-prescribing, while 43% (958) noted positive features. Improved clarity and/or legibility of prescriptions was the most frequently cited advantage of e-prescribing, followed closely by improved speed or efficiency of processing. Prescribing errors were the most commonly cited negative feature of e-prescribing, particularly those stating a wrong drug or wrong directions. CONCLUSION: Pharmacy personnel were generally satisfied with the current status of e-prescribing, but they also perceive key weaknesses in how it has been implemented in physicians' practices and their own organizations. A total of 11 best-practice recommendations are offered to improve e-prescribing in the chain community pharmacy setting.