Pharmacotherapy Interventions by Pharmacists Enhance Medication Safety for Ophthalmology Patients

—Ophthalmologists Improve Prescribing after Drug Therapy Problems Identified—

Abstract

Cases of intervention in pharmacotherapy by pharmacists in the ophthalmology ward were collected and analyzed and the drug information obtained by doing this was provided to ophthalmologists and nurses at a study meeting. This significantly changed the writing of prescriptions by ophthalmologists and helped avoid medication problems.
For each case of intervention by pharmacists in pharmacotherapy, we prepared a “PREAVOID report” and submitted 39 of them to the Japanese Society of Hospital Pharmacists. They were classified according to “pharmaceutical management” and “medicines involved in medication errors”. As for the former, 16 cases (41.0%) came under the heading of drug interactions and duplicate medications and for the latter, 13 cases (33.3%) came under “pre-admission medications”, 15 cases (38.5%) under “medications prescribed by ophthalmologist” and 11 cases (28.2%) under “concomitant use of preadmission medications and those prescribed on-admission”. Thus 24 cases (61.5%) concerned “pre-admission medications”. The study meeting held by pharmacists for ophthalmologists and nurses focused on these medication errors, and was held twice. Afterwards, the frequency of errors significantly decreased-from 13.7×10^-4 (cases/patient/month) before the meetings to 6.8×10^-4 after the meetings (p<0.05).
There was a particularly great improvement as regards the frequency of drug interactions between the antibiotic cefdinir prescribed by ophthalmologists and metal cation medicines included in “pre-admission medications”. The reason for this was discovered by examining the prescribing tendency for metal cation medicines and that of cefdinir for both before and after the meetings. While there was no significant change for metal cation medicines between before and after the meetings (p=0.443), there was a significant decrease in cefdinir prescriptions (p<0.05).