AB1291-HPR IMPLEMENTATION OF AN ELECTRONIC SYSTEM FOR ISSUING PRESCRIPTIONS IN PATIENTS WITH RHEUMATIC DISEASES
Authors: L. Santoyo-Fexas, R. A. Uriarte Botello, C. V. Solis, B. R. Vázquez Fuentes, C. M. Skinner Taylor, I. D. J. Hernandez-Galarza, M. Eguia Bernal, D. Á. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2020)

Background: Pharmacovigilance is the science and activities related to detection, evaluation, understanding and prevention of adverse effects of medications or any other health problem related to them. (1) Within the scope of the pharmacovigilance study, following domains are included: adverse drug reaction, interaction between medications, counterfeit or inferior quality medications, lack of efficacy of medications, misuse or abuse of medications and medication errors (ME). (2) ME is any preventable incident that can cause harm to the patient or lead to improper use of medications when they are under the control of healthcare professionals or the patient. (3) Objectives: To determine the frequency of ME in the prescriptions among rheumatology outpatient’s clinic. Methods: Prospective observational study. Frequency of ME was sought by a randomized review of the prescriptions from rheumatology outpatient’s clinic of the University Hospital “Dr. José Eleuterio González” before and after the implementation of an electronic medical prescription system (REPAIR®) (January 2018-December 2019) REPAIR® displays an automated menu with the stages of the medical prescription: Name, presentation and dosage of the medicine and duration of the treatment. Figure 1. Once the review began, semiannual reports were made to the doctors involved in which frequency of errors and the stage of medical prescription with highest incidence of ME were reported. Figure 1 Example image displayed by REPAIR® Descriptive statistics were performed, reporting frequencies and percentages. Results: A total of 1599 medical prescriptions were evaluated. The number of prescriptions with ME was 196 (12.2%). Table 1 Table 1 General description about errors in medical prescriptions Prescriptions evaluated 1599 Prescription with ME n (% ) 196 (12.2%) Medications evaluated n 10 413 Medications with ME n (% ) 907(8.7%) Average medications per prescription 6.4 Average medications with ME per prescription 0.78 Prescription Stage Name of the drug n (% ) 2/10 413 (0.01%) Medication presentation n (% ) 77/ 10 413 (0.7%) Dose of the drug n (% ) 0/10 413 (0%) Duration of prescription n (% ) 725/10 413 (6.9%) The incidence of ME decreased, at beginning of the study incidence was reported 31.6%, and at the end were 1.5%. Graph 1 The percentage of medications with ME also decreased from 17.2% to 0.8% at the end of the study. Table 2 Table 2 Errors in prescriptions per semester January-June 2018 July-December 2018 January-June 2019 July-December 2019 Prescriptions evaluated n 321 411 407 460 Prescriptions with ME n (% ) 73 (31.6%) 93 (22.6%) 23 (5.6%) 7 (1.5%) Medications evaluated n 2126 2784 2680 2823 Medications with ME n (% ) 367 (17.2%) 469 (16.8%) 36 (1.7%) 35 (0.8%) Average medications per prescription evaluated 6.6 6.7 6.2 6.4 Average medications per prescription evaluated 1.146 1.143 0.082 0.081 Prescription Stage n (% ) Name 1/367(0.2%) 1/469 (0.2%) 0 0 Presentation 37/367 (10%) 37/469 (7.8%) 1/36 (2.7%) 2/35 (5.7%) Dose 0 0 0 0 Duration 290/367 (89%) 367/469 (88.2%) 35/36 (97.2%) 33/35 (94.2%) Conclusion: Decrease in the incidence of ME in rheumatology consultation is important because outcome of the patients depends significantly on treatment adherence. This study results shows that through the application of an electronic prescription system, it is possible to reduce the incidence of ME in rheumatology consultation. References: [1]Jeetu G, Anusha G. Pharmacovigilance: a worldwide master key for drug safety monitoring. J Young Pharm. 2010;2(3):315-20. [2]Organization WH. WHO pharmacovigilance indicators: a practical manual for the assessment of pharmacovigilance systems. 2015. [3]Elden NM, Ismail A. The Importance of Medication Errors Reporting in Improving the Quality of Clinical Care Services. Glob J Health Sci. 2016;8(8):54510. Graph 1 Disclosure of Interests: None declared