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 In March, 2003 the Journal of the American Pharmaceutical Association (JAPA) published a study entitled the National Observational Study of Prescription Dispensing Accuracy and Safety in 50 Pharmacies. This study observed a combination of chain, health system and independent pharmacies and monitored errors made on both new and refilled prescriptions. The results of this study showed little difference between the accuracy rates of the different practice settings or between new or refilled prescriptions. The overall accuracy rate on all new and refilled prescriptions was 98.3%. This means that “four errors occur each day in pharmacies filling 250 prescriptions per day” (JAPA, 2003). Furthermore, according to a recent article published by the Institute for Safe Medication Practices (ISMP, 2005), pharmacy computer weaknesses have shown little improvement over the past six years. This editorial was written in response to a 2005 national survey of pharmacy computer systems conducted by ISMP which showed an alarming number of software programs were not catching potentially critical drug interactions (www.ismp.org/s/Survey200505R.asp).
In addition to the many operational/systems issues which contribute to medication errors, a 1999 study entitled “Psychosocial Factors, Workload, and Risk of Medication Errors” revealed that a variety of psychosocial factors play a role in the accuracy of the workplace (Grasha, 1999). These studies underscore the fact that there are numerous and variable contributing factors to inaccurate medication dispensing, all of which deserve respectful consideration. Historically, monetary fines have been levied against both pharmacists and pharmacies when faced with misfill complaints brought to Boards of Pharmacy. This action has, however, done nothing to address the core issues causing the medication errors. At a time when pharmacists are a precious commodity, it seems imperative that the focus be shifted to identifying problem areas and to improving systems and providing error reduction education.
Over the past decade, much has been written about reducing dispensing errors in pharmacies. As previously stated there are many different areas for focus when identifying the cause of misfills and, as expected, many solutions as well. Your Success RX is a consulting service which is dedicated to a global approach to improving the accuracy of dispensing practices. This mission is accomplished through in-depth auditing of both systems and psychosocial factors influencing medication errors, as well as comprehensive accuracy training of pharmacists and pharmacy personnel. During this training, a strong emphasis is placed on the paramount importance of patient counseling on all new prescriptions leaving a pharmacy. Auditing of systems will be done with the goal of creating ample time for pharmacists to counsel their patients and pharmacists are indoctrinated into a philosophy of Pharmaceutical Care.
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