Impact of Electronic Prescription Audit Process to Reduce Outpatient Medication Errors

This study was undertaken to evaluate the impact of electronic prescription audit for outpatients in a quaternary care hospital. This reviews the clinical benefits of pharmacist driven electronic prescription audit process in monitoring and detecting prescription errors before it reaches the patient. This prospective study was conducted for one year (August 2015-July 2016) by the Department of Clinical Pharmacy, Aster Medcity. During the audit process, each prescription generated through computerized physician order entry will appear immediately in an electronic prescription audit tool which is integrated with a clinical decision support system. Pharmacist audits each outpatient prescription for drug interactions, drug allergies, dosing errors, frequency errors and therapeutic duplications. Clinical decision support system integrated with the audit tool provides brand and monograph details of prescribed drugs and automatic alerts for drug interactions and drug allergies. Pharmacist reported 266 interventions during the study period. Out of that 0.08 % (n=140) errors were prevented before it reached the patient and 0.05 % (n=86) interventions were rejected by physicians with proper justifications. Drug interactions were found to be 0.03 %, wrong drug frequency errors were found to be 0.04 % and drug allergies (prescriptions with pre-identified allergic drugs) were found to be 0.00 5 %. Reported medication errors were categorized according to National Coordinating Council for Medication Error Reporting and Prevention index. Real time audit of outpatient prescriptions using automated prescription audit tool can reduce the risk of harm that arises from prescribing errors, improve the quality of prescriptions, and enhance the safety and quality of the prescribing process.