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Investigation of Simulated Pharmacist Decision Making Involving Prescriptions With a High Probability of Causing Patient Harm
Journal article   Open access   Peer reviewed

Investigation of Simulated Pharmacist Decision Making Involving Prescriptions With a High Probability of Causing Patient Harm

Colleen S Losey, James D Hoehns, Cory Schlobohm and Matthew Witry
The Journal of pharmacy technology, Vol.30(6), pp.207-215
12/2014
DOI: 10.1177/8755122514541548
PMCID: PMC5990156
PMID: 34860908
url
https://doi.org/10.1177/8755122514541548View
Published (Version of record) Open Access

Abstract

Background: Medication errors pose a significant risk to patients, resulting in morbidity, mortality, and unnecessary health care utilization. Pharmacists, using their professional judgment, have an important role as a final check for identifying and resolving these problems. Little is known, however, about pharmacist perspectives and experiences with dispensing or withholding potentially dangerous prescriptions. Objectives : To ( a ) evaluate the extent to which pharmacists would not dispense a likely harmful prescription which has been confirmed by the prescriber and ( b ) assess pharmacist attitudes and experiences with dispensing likely harmful prescriptions. Methods : An anonymous, self-administered, 25-item survey was emailed to members of a state pharmacy association and a pharmacy college alumni list. A series of static prescription vignettes (1 reasonable and 4 likely dangerous doses) were presented and asked if they would fill each prescriber-confirmed prescription. Pharmacists also were asked a series of Likert-type, open-ended, multiple choice, and demographic items regarding their professional experiences and role perceptions. Results : There were 497 usable responses. Three of the 4 dangerous prescriptions were withheld by the majority of pharmacists (sumatriptan as the exception). No demographic variable was universally associated with filling dangerous vignette prescriptions; rather, there were vignette-specific differences. The majority of pharmacists reported refusing to fill a potentially harmful prescription during their career. Conclusions : There appears to be meaningful variation in how pharmacists react when presented with likely harmful prescriptions. More research is needed to better understand this role, its determinants, and the potential effects on patient safety.
 pharmacy education pharmacy ethics medication errors

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