B. Charpiat

Trends in pharmacists' medication order review in French hospitals from 2006 to 2009: analysis of pharmacists' interventions from the Act-IP© website observatory.

The French Society of Clinical Pharmacy has developed a website, named Act‐IP©, enabling hospital pharmacists to document and analyse pharmacists interventions (PIs) proposed during medication order review when a drug‐related problem is detected. This study analyses PIs documented in Act‐IP© and assesses factors associated with physicians acceptance of PIs.

Opportunités d’erreurs médicamenteuses et interventions pharmaceutiques dans le cadre de la prescription informatisée : revue des données publiées par les pharmaciens hospitaliers français

INTRODUCTIONnComputerized prescription order entry (CPOE) is accelerating in France. CPOE has been shown to reduce the occurrence of some medication errors, but evidence of a beneficial effect on clinical outcomes remains limited. In some cases, new error types have arisen with its use. The aim of this study was to investigate the French data on the nature and frequency of medication errors opportunities generated by the computer use, which led pharmacists to alert prescribers.nnnMETHODSnWe performed a search on PubMed and CAT-INIST databases completed by a manual one.nnnRESULTSnTen publications, 11 abstracts and three personal communications were analysed. As part of the analysis of computerized prescriptions, the rate of pharmaceutical interventions due to CPOE ranges from 5.9 to 35% depending on the study. Duplicate orders, unit errors, the use of free text, parameterization flaws and poor usability of software are probably the root of many prescribing errors. Errors generated by the tool can have serious potential consequences.nnnDISCUSSIONnPharmacists interventions due to CPOE are common. It is not known whether variability of the percentage of pharmacists interventions is due to software used or to conditions by witch studies were carried out. With implementation of CPOE in hospital, pharmacists must acquire new knowledge and new skills in order to prevent prescription errors generated by these tools and its misuse.nnnCONCLUSIONnStudies are urgently needed in order to identify the safest tools and to discard the most dangerous.

Revue généraleOpportunités d’erreurs médicamenteuses et interventions pharmaceutiques dans le cadre de la prescription informatisée : revue des données publiées par les pharmaciens hospitaliers françaisOpportunities for medication errors and pharmacist's interventions in the context of computerized prescription order entry: A review of data published by French hospital pharmacists

INTRODUCTIONnComputerized prescription order entry (CPOE) is accelerating in France. CPOE has been shown to reduce the occurrence of some medication errors, but evidence of a beneficial effect on clinical outcomes remains limited. In some cases, new error types have arisen with its use. The aim of this study was to investigate the French data on the nature and frequency of medication errors opportunities generated by the computer use, which led pharmacists to alert prescribers.nnnMETHODSnWe performed a search on PubMed and CAT-INIST databases completed by a manual one.nnnRESULTSnTen publications, 11 abstracts and three personal communications were analysed. As part of the analysis of computerized prescriptions, the rate of pharmaceutical interventions due to CPOE ranges from 5.9 to 35% depending on the study. Duplicate orders, unit errors, the use of free text, parameterization flaws and poor usability of software are probably the root of many prescribing errors. Errors generated by the tool can have serious potential consequences.nnnDISCUSSIONnPharmacists interventions due to CPOE are common. It is not known whether variability of the percentage of pharmacists interventions is due to software used or to conditions by witch studies were carried out. With implementation of CPOE in hospital, pharmacists must acquire new knowledge and new skills in order to prevent prescription errors generated by these tools and its misuse.nnnCONCLUSIONnStudies are urgently needed in order to identify the safest tools and to discard the most dangerous.

Validation of a tool for reporting pharmacists' interventions in everyday community pharmacy

The French Society of Clinical Pharmacy (SFPC) asked a group of experts to adapt the SFPC hospital pharmacists interventions reporting tool for use in community pharmacy practice. This study aimed to develop and validate a tool for the routine reporting of pharmacists interventions in French community settings.

Tools for Assessing Potential Significance of Pharmacist Interventions: A Systematic Review

IntroductionAssessing the significance of pharmacist interventions (PIs) is essential to demonstrate the added value of pharmacists. Methods and tools for assessing the potential significance of PIs are diverse and their properties are questionable.ObjectivesWe aimed to systematically review the tools available to assess the potential significance of PIs.MethodsWe conducted a systematic search for English- or French-language publications from 1986 to 2013 in PubMed, PsycINFO, PASCAL, and CINAHL. Studies were screened by two independent reviewers based on inclusion/exclusion criteria and were abstracted for content, structure of tools, and validation process.ResultsOf 873 citations screened, 82 distinct tools were identified from 133 studies. While clinical aspects were often defined quite clearly, terminology regarding humanistic, economic, and process-related aspects of PIs was omitted, incomplete, or ambiguous in most tools. The probabilities of consequences of PIs/drug-related problems were evaluated in 20/82 tools. Few tools simultaneously measured economic, clinical, humanistic, and process-related variables. Structure of the tools varied from an implicit, mono-dimensional tool to an explicit, multi-dimensional algorithm. Validation processes were diverse in terms of quantification and number of raters, rating method, and psychometric parameters. Of 133 identified studies, there was limited evidence of validity (8/133, 6.0xa0%), inter-rater reliability (49/133, 36.8xa0%), and intra-rater reliability (2/133, 1.5xa0%).ConclusionsThe majority of tools focused primarily on assessing clinical aspects and failed to detect comprehensive impacts. The heterogeneity of tools and assessment processes hindered our ability to synthesize the results of evaluations. Limited results for their validity and reliability cast doubt on the credibility of this methodology for justification of the value of PIs. Recommendations for development of tools with optimal theoretical, pragmatic, and psychometric properties are proposed.

Classifying pharmacists' interventions recorded in observational databases: Are they all necessary and appropriate?

Over the past 25 years in various countries, researchers have developed tools for recording pharmacists interventions (PIs) and observational databases aimed at the exhaustive collection of these interventions. The large amount of published data contrasts strikingly with the fact that little attention has been paid to defining the different types of PIs from a theoretical point of view. Whatever the paper we read on this topic, each PI is presented as necessary and appropriate. We suggest this customary approach is biased and that the reality is somewhat more subtle. In order to better reflect the real world, we propose a new approach to the classification of PIs that is based on whether they are present or absent in observational databases, and we explain how to identify the absent ones. Present and absent PIs can be subdivided in two additional categories: appropriate and inappropriate ones. This additional classification should encourage pharmacists to critically examine and evaluate their practice and subsequently improve their ability to identify drug related problems in clinical practice.