Barriers and facilitators to recovering from e-prescribing errors in community pharmacies.
Ontology highlight
ABSTRACT:
SUBMITTER: Odukoya OK
PROVIDER: S-EPMC4312611 | biostudies-literature | 2015 Jan-Feb
REPOSITORIES: biostudies-literature
Publications
Barriers and facilitators to recovering from e-prescribing errors in community pharmacies.
Odukoya Olufunmilola K OK Stone Jamie A JA Chui Michelle A MA
Journal of the American Pharmacists Association : JAPhA 20150101 1
<h4>Objective</h4>To explore barriers and facilitators to recovery from e-prescribing errors in community pharmacies and to explore practical solutions for work system redesign to ensure successful recovery from errors.<h4>Design</h4>Cross-sectional qualitative design using direct observations, interviews, and focus groups.<h4>Setting</h4>Five community pharmacies in Wisconsin.<h4>Participants</h4>13 pharmacists and 14 pharmacy technicians.<h4>Interventions</h4>Observational field notes and tran ...[more]
Similar Datasets
Project description:BackgroundCommunity pharmacies are easily accessible for self-care advice. Guidelines for providing self-care advice were introduced in several countries, including the Netherlands in the 1990s. Previous studies have indicated room for improvement in self-care advice in daily pharmacy practice.AimTo identify barriers and facilitators for providing self-care advice.MethodSemi-structured interviews were conducted face-to-face or online with pharmacists and pharmacy assistants using a topic guide based on the Theoretical Domains Framework. The interviews were audio-recorded and transcribed verbatim. The transcripts were deductively analysed to identify barriers and facilitators for self-care counselling. COREQ guidelines were followed.ResultsIn total, 13 pharmacists and 12 pharmacy assistants were interviewed to reach data saturation. In general, most themes addressed by pharmacists and pharmacy assistants belonged to similar domains. The following domains were frequently mentioned: environmental context and resources (e.g. priority for prescription drugs, privacy, collaboration with general practitioners, access to patients' records), intentions (providing reliable advice), skills (communication, decision-making), knowledge (ready guideline knowledge), beliefs about consequences (patient safety), social influences (patient awareness of pharmacist role), reinforcement (lack of reimbursement for relatively time-consuming advice).ConclusionThis study identifies barriers and facilitators for evidence-based self-care advice. Pharmacists should first support pharmacy assistants by helping them keep their knowledge and skills up to date and creating suitable pharmacy preconditions to facilitate improvements in self-care counselling. Second, collaboration with general practitioners regarding minor ailments should be improved.
| S-EPMC10082626 | biostudies-literature
Project description:Significant numbers of human immunodeficiency virus (HIV) infections are transmitted unknowingly, making efforts to increase HIV testing accessibility crucial. As trusted healthcare providers, pharmacists can increase accessibility of HIV screening and referral services. However, challenges with lack of private counseling and testing space, need for training and education, lack of adequate staffing, heavy workload, and uncertainty supporting patients with reactive results have been previously reported by community pharmacists as barriers to offering HIV screening. The objective of this study was to investigate pharmacists' opinions of strategies for addressing these barriers. A survey was developed to gather information regarding steps that could be taken to increase pharmacist comfort and interest offering HIV point-of-care testing (POCT) services. Thirty pharmacies were contacted and representatives from twenty-six responded. Pharmacists reported that they were likely or very likely to offer HIV POCT if they were given the following: a 2 h training session on administering and interpreting HIV POCT (73%); a 4 h education session on a variety of HIV education topics (73%); training about couples testing, post-test counseling, and de-escalation techniques (58%); or a semi-annual CE training (58%). Pharmacist respondents were likely or very likely (81%) to implement HIV POCT if there was a protocol in place so that patients with a reactive screening would out be referred for diagnostic testing and if there was a script provided as a template for post-test counseling (81%). The majority of pharmacists (69%) also preferred the appointment-based model rather than a walk-in or combination option and preferred (77%) having 20-30 min of dedicated time with the patient to provide adequate testing, education, and counseling. By using these strategies to improve comfort and likelihood implementing HIV POCT, pharmacists can increase access to HIV testing and decrease the spread of HIV.
| S-EPMC8167761 | biostudies-literature
Project description:Little is known about the frequency and types of prescribing errors in the ambulatory setting among community-based, primary care providers. Therefore, the rates and types of prescribing errors were assessed among community-based, primary care providers in two states.A non-randomized cross-sectional study was conducted of 48 providers in New York and 30 providers in Massachusetts, all of whom used paper prescriptions, from September 2005 to November 2006. Using standardized methodology, prescriptions and medical records were reviewed to identify errors.9385 prescriptions were analyzed from 5955 patients. The overall prescribing error rate, excluding illegibility errors, was 36.7 per 100 prescriptions (95% CI 30.7 to 44.0) and did not vary significantly between providers from each state (p=0.39). One or more non-illegibility errors were found in 28% of prescriptions. Rates of illegibility errors were very high (175.0 per 100 prescriptions, 95% CI 169.1 to 181.3). Inappropriate abbreviation and direction errors also occurred frequently (13.4 and 4.2 errors per 100 prescriptions, respectively). Reviewers determined that the vast majority of errors could have been eliminated through the use of e-prescribing with clinical decision support.Prescribing errors appear to occur at very high rates among community-based primary care providers, especially when compared with studies of academic-affiliated providers that have found nearly threefold lower error rates. Illegibility errors are particularly problematical.Further characterizing prescribing errors of community-based providers may inform strategies to improve ambulatory medication safety, especially e-prescribing.http://www.clinicaltrials.gov, NCT00225576.
| S-EPMC3384098 | biostudies-literature
Project description:The pharmacist prescribing service was legally permitted in 2019 in Switzerland to face challenges in the health system; however, there has been a lack of implementation. The aims of this study were to identify implementation factors and to evaluate pharmacy association interventions that aim to support implementation. A qualitative study with two methods was carried out: (1) twelve semi-structured interviews with community pharmacists were recorded, transcribed, and a thematic analysis was carried out using the Consolidated Framework of Implementation Research (CFIR); (2) questionnaires were submitted to the six pharmacy associations of French-speaking Switzerland. The main barriers found were non-reimbursement by health insurance companies, medications' lack of clinical relevance, a negative perception of GPs, and a lack of time. The main facilitators were the availability of service information, pharmacies belonging to chains/groups, a reduction in the medical consultation burden, and the accessibility of pharmacies. Five associations answered, revealing different initiatives supporting implementation, but none of them had strategies at the political level nor communication strategies aimed at patients or GPs. Based on the CFIR, the most frequent implementation factors were highlighted, and this classification facilitates the transposition of the results to other contexts. The results will allow the development of targeted strategies and add the role of the pharmacy associations, which should be considered in future studies.
| S-EPMC10661259 | biostudies-literature
Project description:IntroductionNon-medical prescribing has the potential to deliver innovative healthcare within limited finances. However, uptake has been slow, and a proportion of non-medical prescribers do not use the qualification. This systematic review aimed to describe the facilitators and barriers to non-medical prescribing in the United Kingdom.MethodsThe systematic review and thematic analysis included qualitative and mixed methods papers reporting facilitators and barriers to independent non-medical prescribing in the United Kingdom. The following databases were searched to identify relevant papers: AMED, ASSIA, BNI, CINAHL, EMBASE, ERIC, MEDLINE, Open Grey, Open access theses and dissertations, and Web of Science. Papers published between 2006 and March 2017 were included. Studies were quality assessed using a validated tool (QATSDD), then underwent thematic analysis. The protocol was registered with PROSPERO (CRD42015019786).ResultsOf 3991 potentially relevant identified studies, 42 were eligible for inclusion. The studies were generally of moderate quality (83%), and most (71%) were published 2007-2012. The nursing profession dominated the studies (30/42). Thematic analysis identified three overarching themes: non-medical prescriber, human factors, and organisational aspects. Each theme consisted of several sub-themes; the four most highly mentioned were 'medical professionals', 'area of competence', 'impact on time' and 'service'. Sub-themes were frequently interdependent on each other, having the potential to act as a barrier or facilitator depending on circumstances.DiscussionAddressing the identified themes and subthemes enables strategies to be developed to support and optimise non-medical prescribing. Further research is required to identify if similar themes are encountered by other non-medical prescribing groups than nurses and pharmacists.
| S-EPMC5927440 | biostudies-literature
Project description:IntroductionFatal overdoses from opioids increased four-fold from 1999 to 2009, and they are now the leading cause of death among Americans under 50. Legislation has been passed by every state to increase access to naloxone but dispensing by community pharmacies remains low.ObjectivesThe objective of this study was to pilot test a proactive opioid overdose counseling intervention and a passive naloxone intervention, and the implementation strategies developed to support their delivery, in rural community pharmacies on relevant implementation outcomes.MethodsThe interventions, implementation strategies, and the overall pilot study approach were developed in a collaborative partnership with a regional supermarket pharmacy chain. They selected 2 rural pharmacies to participate in the pilot study and 2 non-intervention pharmacies to serve as comparison sites. Two interventions were pilot tested in the 2 intervention pharmacies: 1)a proactive opioid overdose counseling intervention and 2) a passive naloxone intervention. An explanatory sequential mixed-methods design was utilized to evaluate adoption, feasibility, acceptability, and appropriateness outcomes after the 3-month observation period.ResultsBetween the 2 intervention pharmacies, 130 patients received the opioid overdose counseling intervention. 44 (33.8%) were prescribed and dispensed naloxone. Zero naloxone prescriptions were written or dispensed at the comparison pharmacies. Interviews with pharmacy staff found the interventions to be feasible, acceptable, and appropriate in their settings.ConclusionThis small scale pilot study in partnership with a regional supermarket pharmacy chain had positive results with a third of patients who received the opioid overdose counseling intervention being dispensed naloxone. However, the majority of patients did not receive naloxone indicating additional revisions to the intervention components and/or implementation strategies are needed to improve the overall impact of the interventions.
| S-EPMC8813166 | biostudies-literature
Project description:IntroductionPre-exposure prophylaxis (PrEP) is an effective medication to reduce the risk of acquiring HIV. PrEP is available free of charge in the UK from sexual health clinics. Expanding PrEP delivery to community pharmacies holds promise and aligns with UK government goals to eliminate new cases of HIV by 2030. The aim of this scoping review was to describe the existing evidence about the barriers to and facilitators of community pharmacy oral PrEP delivery, for pharmacists and pharmacy clients, as aligned with the Capacity Opportunity, Motivation Behaviour (COM-B) Model.MethodsFive bibliographic and five review databases were searched from inception to August 2023. Literature of any study design was included if it discussed barriers and facilitators of community pharmacy PrEP delivery. Trial registrations, protocols and news articles were excluded.ResultsA total of 649 records were identified, 73 full texts were reviewed and 56 met the inclusion criteria, predominantly from high-income/westernized settings. Most of the included literature was original research (55%), from the United States (77%) conducted during or after the year 2020 (63%). Barriers to PrEP delivery for pharmacists included lack of knowledge, training and skills (capability), not having the necessary facilities (opportunity), concern about the costs of PrEP and believing that PrEP use could lead to risk behaviours and sexually transmitted infections (motivation). Facilitators included staff training (capability), time, the right facilities (opportunity), believing PrEP could be a source of profit and could reduce new HIV acquisitions (motivation). For clients, barriers included a lack of PrEP awareness (capability), pharmacy facilities (opportunity) and not considering pharmacists as healthcare providers (motivation). Facilitators included awareness of PrEP and pharmacist's training to deliver it (capability), the accessibility of pharmacies (opportunity) and having an interest in PrEP (motivation).DiscussionTo effectively enhance oral PrEP delivery in UK community pharmacies, the identified barriers and facilitators should be explored for UK relevance, addressed and leveraged at the pharmacy team, client and care pathway level.ConclusionsBy comprehensively considering all aspects of the COM-B framework, community pharmacies could become crucial providers in expanding PrEP accessibility, contributing significantly to HIV prevention efforts.
| S-EPMC10945033 | biostudies-literature
Project description:BackgroundIntravenous (IV) medication is commonly administered and closely associated with patient safety. Although nurses dedicate considerable time and effort to rate the control of IV medications, many medication errors have been linked to the wrong rate of IV medication. Further, there is a lack of comprehensive studies examining the literature on rate control of IV medications. This study aimed to identify the attributes of errors, facilitators, and barriers related to rate control of IV medications by summarizing and synthesizing the existing literature.MethodsThis scoping review was conducted using the framework proposed by Arksey and O'Malley and PRISMA-ScR. Overall, four databases-PubMed, Web of Science, EMBASE, and CINAHL-were employed to search for studies published in English before January 2023. We also manually searched reference lists, related journals, and Google Scholar.ResultsA total of 1211 studies were retrieved from the database searches and 23 studies were identified from manual searches, after which 22 studies were selected for the analysis. Among the nine project or experiment studies, two interventions were effective in decreasing errors related to rate control of IV medications. One of them was prospective, continuous incident reporting followed by prevention strategies, and the other encompassed six interventions to mitigate interruptions in medication verification and administration. Facilitators and barriers related to rate control of IV medications were classified as human, design, and system-related contributing factors. The sub-categories of human factors were classified as knowledge deficit, performance deficit, and incorrect dosage or infusion rate. The sub-category of design factor was device. The system-related contributing factors were classified as frequent interruptions and distractions, training, assignment or placement of healthcare providers (HCPs) or inexperienced personnel, policies and procedures, and communication systems between HCPs.ConclusionsFurther research is needed to develop effective interventions to improve IV rate control. Considering the rapid growth of technology in medical settings, interventions and policy changes regarding education and the work environment are necessary. Additionally, each key group such as HCPs, healthcare administrators, and engineers specializing in IV medication infusion devices should perform its role and cooperate for appropriate IV rate control within a structured system.
| S-EPMC10717502 | biostudies-literature
Project description:BackgroundNon-medical prescribing is one healthcare reform strategy that has the potential to create health system savings and offer equitable and timely access to scheduled medicines. Podiatrists are well positioned to create health system efficiencies through prescribing, however, only a small proportion of Australian podiatrists are endorsed to prescribe scheduled medicines. Since scheduled medicines prescribed by Australian podiatrists are not subsidised by the Government, there is a lack of data available on the prescribing practices of Australian podiatrists. The aim of this research was to investigate the prescribing practices among Australian podiatrists and to explore barriers and facilitators that influence participation in endorsement.MethodsParticipants in this quantitative, cross-sectional study were registered and practicing Australian podiatrists who were recruited through a combination of professional networks, social media, and personal contacts. Respondents were invited to complete a customised self-reported online survey, developed using previously published research, research team's expertise, and was piloted with podiatrists. The survey contained three sections: demographic data including clinical experience, questions pertaining to prescribing practices, and barriers and facilitators of the endorsement pathway.ResultsRespondents (n = 225) were predominantly female, aged 25-45, working in the private sector. Approximately one quarter were endorsed (15%) or in training to become endorsed (11%). Of the 168 non-endorsed respondents, 66% reported that they would like to undertake training to become an endorsed prescriber. The most common indications reported for prescribing or recommending medications include nail surgery (71%), foot infections 474 (88%), post-operative pain (67%), and mycosis (95%). The most recommended Schedule 2 medications were ibuprofen, paracetamol, and topical terbinafine. The most prescribed Schedule 4 medicines among endorsed podiatrists included lignocaine (84%), cephalexin (68%), flucloxacillin (68%), and amoxicillin with clavulanic acid (61%).ConclusionPodiatrists predominantly prescribe scheduled medicines to assist pain, inflammatory, or infectious conditions. Only a small proportion of scheduled medicines available for prescription by podiatrists with endorsed status were reportedly prescribed. Many barriers exist in the current endorsement for podiatrists, particularly related to training processes, including mentor access and supervised practice opportunities. Suggestions to address these barriers require targeted enabling strategies.
| S-EPMC8822637 | biostudies-literature
Project description:BackgroundOpiate agonist therapy (OAT) prescribing rates by family physicians are low in the context of community-based, comprehensive primary care. Understanding the factors that support and/or inhibit OAT prescribing within primary care is needed. Our study objectives are to identify and synthesize documented barriers to, and facilitators of, primary care opioid agonist prescribing, and effective strategies to inform intervention planning and support increased primary care OAT prescribing.Methods/designWe will systematically search EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, MEDLINE, and gray literature in three domains: primary care providers, opioid agonist therapy, and opioid abuse. We will retain and assess primary studies reporting documented participation, or self-reported willingness to participate, in OAT prescribing; and/or at least one determinant of OAT prescribing; and/or strategies to address determinants of OAT prescribing from the perspective of primary care providers in comprehensive, community-based practice settings. There will be no restrictions on study design or publication date. Studies limited to specialty clinics with specialist prescribers, lacking extractable data, or in languages other than English or French will be excluded. Two reviewers will perform abstract review and data extraction independently. We will assess the quality of included studies using the Joanna Briggs Institute Critical Appraisal Tool. We will use a framework method of analysis to deductively code barriers and facilitators and to characterize effective strategies to support prescribing using a combined, modified a priori framework comprising the Theoretical Domains Framework and the Consolidated Framework for Implementation Research.DiscussionTo date, no synthesis has been undertaken of the barriers and facilitators or effective interventions promoting OAT prescribing by primary care clinicians in community-based comprehensive care settings. Enacting change in physician behaviors, community-based programming, and health services is complex and best informed by using theoretical frameworks that allow the analysis of the available data to assist in designing and implementing interventions. In light of the current opioid crisis, increasing the capacity of primary care clinicians to provide OAT is an important strategy to curb morbidity and mortality from opioid use disorder.Systematic review registrationPROSPERO CRD86835.
| S-EPMC6657163 | biostudies-literature