Nature and frequency of prescription modifications in community pharmacies: A nationwide study in the Netherlands

• Published in: British journal of clinical pharmacology Vol. 87; no. 3; pp. 1455 - 1465
• Main Authors: Loon, W.E. (Ellen), Borgsteede, S.D. (Sander), Baas, G.W. (Gert), Kruijtbosch, M. (Martine), Buurma, H. (Henk), De Smet, P.A.G.M. Peter, Egberts, A.C.G. (Toine), Bouvy, M. (Marcel), Floor‐Schreudering, A. (Annemieke)
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 01.03.2021
• Subjects: community pharmacy; drug‐related problems; interventions; medication errors; medication safety; Original; pharmacists; prescribing errors; prescription modifications; primary health care; medication safety; interventions; pharmacists; prescribing errors; primary health care; community pharmacy; prescription modifications; drug-related problems; medication errors
• ISSN: 0306-5251; 1365-2125
• DOI: 10.1111/bcp.14548

Aims To investigate the nature and frequency of prescription modifications in Dutch community pharmacies. Methods In this cross‐sectional study, Dutch community pharmacists documented prescription modifications in their pharmacy during 1 predetermined day. Pharmacists from all Dutch community pharmacies were invited to participate. A prescription modification was defined as any modification in a prescription for a medicine or other healthcare product because of an administrative problem, logistic issue or potential drug‐related problem (DRP). All documented modifications were assessed to establish the nature and frequency of prescription modifications. Results Pharmacists in 275 pharmacies completed the study. A modification was performed in 5.5% of all prescriptions. 1.3% of the prescriptions contained an administrative problem, of which insufficient specification of the dosing regimen was most common (63.1%). A modification was performed due to a logistic issue in 2.4% of the prescriptions. The most frequently recorded issues were unavailability of medication (40.9%) and obligatory product substitutions due to reimbursement policies (33.2%). A modification was performed in 1.8% of the prescriptions to solve or prevent potential DRPs. Of these, 69.2% was potentially clinically relevant according to the pharmacist concerned. The most frequently prevented potential DRP was an incorrect strength or dose (31.9%). Conclusion Dutch community pharmacists modified almost 1 in 20 prescriptions per pharmacy. The nature of the modifications reflects current community pharmacy practice, in which pharmacists frequently deal with logistic issues and intervene to solve or prevent for DRPs several times a day. The majority of the DRPs were considered to be potentially clinically relevant.