Evaluation of a modified prescription form to address prescribing errors

Kennedy, Amanda G.; Littenberg, Benjamin; Callas, Peter W.; Carney, Jan K.
January 2011
American Journal of Health-System Pharmacy;1/15/2011, Vol. 68 Issue 2, p151
Academic Journal
Purpose. The impact of a modified paper prescription form on the occurrence of prescribing errors was evaluated. Methods. Rural primary care providers practicing in the United States who wrote paper prescriptions in English were eligible for study participation. The prescribers agreed to use only the prescription pads provided to them during the study. The study prescription pads contained 50 prescription forms, each with a duplicate. Each prescription and duplicate contained a unique serial number for data identification purposes. When a prescriber wrote a prescription, the original was provided to the patient per usual practice, and the duplicate was retained as the study data. Two prescription pads contained modified forms and two prescription pads were similar to the prescription pads the prescriber had been using. Providers completed 100 standard and 100 modified prescriptions. Pharmacist consultants reviewed each prescription for the presence or absence of errors. The primary outcome measure was the number of errors. Secondary outcomes were risk differences between standard and modified prescription forms for various error types. Results. Of the 327 prescribers who were eligible and expressed interest in the study, 111 started the study and 84 completed the study. A total of 16,061 prescriptions were eligible for analysis. Pharmacists identified at least one prescribing problem in 987 prescriptions (6.1%). Modified prescription forms were associated with significantly more prescribing problems than standard prescription forms (odds ratio, 1.85; 95% confidence interval, 1.5-2.2; p < 0.001). Conclusion. Modified prescription forms were associated with more errors than were standard prescription forms in a sample of rural prescribers.


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