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Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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pharmacy auditJuly 15 2015

Medicines supply and availability issues account for a fifth (20.5%) of pharmacist interventions over prescriptions, an audit has found.

Almost as frequent are unsigned prescriptions (accounting for 18.0% of interventions), followed by problems over the medicine format (7.9%), prescribed quantity (6.8%) and drug item or brand (6.7%).

The figures appear in the report ‘Prescription interventions: Practice-based Audit 2014-15’ published by Pharmacy Voice, the body representing pharmacy owners. It includes data collated from 5,198 community pharmacy multiples and independents, which recorded a total of 113,471 interventions during a two week period.

“Based on an estimated figure of 3,131 as the average number of items that a community pharmacy dispenses over a two week period, this suggests an intervention rate of 0.70% or 7 interventions per 1,000 items,” says the report. “Cautious extrapolation of these figures suggests that community pharmacy teams in England intervene on a possible 6.6 million prescription items every year.”

It also estimates that for the interventions where the ‘potential level of harm prevented’ was recorded, potentially “one in ten of the issues encountered with prescriptions could have resulted in a serious incident of it had not been for the pharmacist’s intervention.”

However as extent of ‘seriousness’ can be subjective, and the nature of potential harm was not recorded in half of the interventions, the report suggests that “somewhere between 5 and 10% of the interventions made by pharmacists every day prevent moderate or severe harm from being caused.”

In addition, “the audit has provided further evidence that medicines shortages are still widespread and that this persists as a growing problem for patients and the public, highlighting the need for action on this issue.”

Commenting on the findings, Rob Darracott, chief executive of Pharmacy Voice, said: “Audits such as this highlight the positive impact community pharmacy teams have on patient care, but the management of these interventions necessitates more time spent, and considerable pressure for all members of the primary care team. This means it is essential that steps are taken to reduce the need for interventions.

“Patient safety is a key priority for Pharmacy Voice and we believe that tackling this will improve safety as well as efficiency. Pharmacy Voice continues to advocate strongly for closer joint working between GPs and pharmacy teams to reduce errors, increase learning, improve the patient journey, drive efficiency and reduce delays to patients safely receiving their medicines.”

Its Patient Safety Group will use the audit findings to better understand how community pharmacy teams can improve any of their own procedures to benefit patient care and safety.

“Pharmacy Voice expects that the recently proposed access to Summary Care Record will have a positive effect on our next audit results,” added Mr Darracott. “This is an encouraging first step to what we hope will be full read/write access to patient records, enabling pharmacy teams to give better patient care and help provide a more consistent primary care service to patients.”

He said that Pharmacy Voice will also continue to work closely with industry bodies, including the British Generic Manufacturers Association, British Association of Pharmaceutical Wholesalers, and the Association of the British Pharmaceutical Industry, on the matter. It will continue “to contribute to the work of the Department of Health Supply Chain Group on medicines shortages, in order to ensure that a rapid resolution is found for patients and pharmacy teams.”

Links:

Pharmacy Voice announcement    

Pharmacy Voice ‘Prescription interventions: Practice-based Audit 2014/15’    

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