[Prescription changes in pharmacies].

Abstract

BACKGROUND: Prescriptions must sometimes be changed or clarified before dispensing in order to provide a safe and professional service. The aims of this study were to gain insight into the types of prescription interventions performed by pharmacists, to explore the reason behind the interventions and to describe to which extent and how interventions are documented and communicated to the prescribers. MATERIAL AND METHODS: Prescription interventions (N = 1,084) performed at a community pharmacy in Norway from January 2002 to September 2004 were categorised. Two focus groups were used to validate the categories. The pharmacists in these groups were invited to discuss working procedures and professional judgements related to prescription interventions. RESULTS: The prescription interventions were grouped into seven categories. The two largest categories were "drugs not available" (37%) and "clarification of drug choice and dosage" (22%). Many interventions are not communicated to the prescribers. In principal, the pharmacists felt that interventions should be communicated to the prescriber even if this is often not the case. CONCLUSION: Pharmacists intervene on a range of prescription issues that are not communicated to the prescribers. Feedback requires time and resources for all involved. By ensuring that computer systems used by general practitioners comply with reimbursement legislation and technical requirements for prescriptions, the demand for many prescription interventions will be reduced. There is a need for a joint professional discussion on differentiation and standardisation of feedback on prescription interventions.