약사에 의한 항암처방 중재 분석 및 처방 오류 개선 효과
Analysis of intervention in chemotherapy prescription and improvement in prevention of prescribing errors by the pharmacist
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Chemotherapy prescription shows high frequency of prescription changes and errors, according to the condition of the patient and their response to such treatment. Therefore, occurrence of problems in the patient’s safety control might cause extended period of treatment and increasing possibilities of adverse reactions. This study is aimed to analyze the current status of the prescription intervention, to estimate the importance of prescription review by the pharmacist, and to assess the role of the pharmacist to prevent prescription errors. From January to August in 2010, in the oncology department of our hospital, 16,754 chemotherapy prescriptions were examined and 539 of them had prescribing errors, which were corrected by the pharmacists. In order to find the effectiveness of using computerized chemotherapy protocol, trans-arterial chemoembolization (TACE) protocols of gastroenterology, which were newly registered and pediatric chemotherapy protocols, which were modified from the existing protocols have been analyzed in difference of error incidence during the data collecting period. As a result of analyzing the prescribing errors, the errors about infusion solution contained 290 cases (53.8%) that were related to the final concentration of the diluted solution and 70 cases (13.0%) with missing infusion solution for dilution. Among the errors about dosage, 33 cases (6.1%) were intervened for exceeding the maximum dose, 30 cases (5.6%) for inputting wrong indicators, which determined chemotherapy dose, and 29 cases (5.4%) for mistake of entering dosage. The number of error cases in selecting chemotherapy protocol and entering drug code was 27(5.0%) and 26(4.8%), respectively. The prescribing errors before and after using TACE protocols showed a significant decrease (p=0.0002). In case of pediatric clinic, the prescribing errors, before and after modifying protocols were 3.1% and 2.7%, respectively. Although the prescribing errors after correcting system decreased compared to that of the former protocol use, statistical value has not been proven (p=0.409). The results showed that the prescribing error decreased after entering new protocols or correcting the protocols, thus, the study can convince medical staffs to use chemotherapy protocols for a decrease in the prescription errors. But, also prescription review and intervention, considering the individual specific medical information by pharmacist, will make chemotherapeutic agents to be administered safely to cancer patients.
Abstract
Chemotherapy prescription shows high frequency of prescription changes and errors, according to the condition of the patient and their response to such treatment. Therefore, occurrence of problems in the patient’s safety control might cause extended period of treatment and increasing possibilities of adverse reactions. This study is aimed to analyze the current status of the prescription intervention, to estimate the importance of prescription review by the pharmacist, and to assess the role of the pharmacist to prevent prescription errors. From January to August in 2010, in the oncology department of our hospital, 16,754 chemotherapy prescriptions were examined and 539 of them had prescribing errors, which were corrected by the pharmacists. In order to find the effectiveness of using computerized chemotherapy protocol, trans-arterial chemoembolization (TACE) protocols of gastroenterology, which were newly registered and pediatric chemotherapy protocols, which were modified from the existing protocols have been analyzed in difference of error incidence during the data collecting period. As a result of analyzing the prescribing errors, the errors about infusion solution contained 290 cases (53.8%) that were related to the final concentration of the diluted solution and 70 cases (13.0%) with missing infusion solution for dilution. Among the errors about dosage, 33 cases (6.1%) were intervened for exceeding the maximum dose, 30 cases (5.6%) for inputting wrong indicators, which determined chemotherapy dose, and 29 cases (5.4%) for mistake of entering dosage. The number of error cases in selecting chemotherapy protocol and entering drug code was 27(5.0%) and 26(4.8%), respectively. The prescribing errors before and after using TACE protocols showed a significant decrease (p=0.0002). In case of pediatric clinic, the prescribing errors, before and after modifying protocols were 3.1% and 2.7%, respectively. Although the prescribing errors after correcting system decreased compared to that of the former protocol use, statistical value has not been proven (p=0.409). The results showed that the prescribing error decreased after entering new protocols or correcting the protocols, thus, the study can convince medical staffs to use chemotherapy protocols for a decrease in the prescription errors. But, also prescription review and intervention, considering the individual specific medical information by pharmacist, will make chemotherapeutic agents to be administered safely to cancer patients.
참고문헌 (13)
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