Prescription-writing patterns and errors in a family medicine residency program.

Copies of 1814 prescriptions written by 20 residents were reviewed to determine prescribing patterns and the incidence of prescription-writing errors. An average of 0.69 prescriptions were written per patient visit at an average cost (to the pharmacist) of $13.35. Over one third of all prescriptions were written using the generic name, and "dispense as written" was specified on only 3.25%. On average, 21% (n = 373) of all prescriptions collected contained at least one prescription-writing error. Errors were characterized as omissions (6%), unfulfilled legal requirements (1%), incomplete directions (1%), dose or direction errors (3%), unclear quantity to be dispensed (3%), or prescriptions written for nonprescription products (5%). A correct diagnosis and treatment plan can be undermined by a written prescription that is incorrect or miscommunicates the intention of the prescriber.

Using self-evaluation to maintain competence.

This limited study examined differences in pharmacists' competencies through self-assessment. By using self-assessment with specified objectives, pharmacists can target areas for CE programs. Pharmacists can then improve and maintain their competencies in these specific areas. A future study could focus on discovering the reasons some pharmacists do not feel comfortable in giving advice/information to other healthcare professionals.

Improving prescription-writing skills in a family practice residency.

The objective of this study was to evaluate a novel method of physician education that uses copies of prescriptions written by study participants to provide feedback on their prescription-writing skills. A prospective, blind, completely random before-after design was used, with observation, intervention, and postintervention periods, each lasting four months. The study group comprised 20 family practice residents, stratified by year of training and randomly assigned to treatment or control groups. Copies of all prescriptions written by participating residents were evaluated for prescription-writing errors. During the intervention phase, prescription copies with errors were returned to the treatment group residents with a tactful comment pointing out the error and suggesting changes. Over the three time periods, there was a continuous decline in the rate of prescription-writing errors in the treatment group, but not in the control group. A significant number of physicians who received the feedback improved their prescription writing (p less than 0.01), but logistic regression failed to show a difference attributable to the intervention. In conclusion, written feedback on copies of prescriptions produced a small decrease in the number of prescription-writing errors. Further, long-term study may show a magnified effect of this teaching method.