院外処方箋の疑義照会簡素化の取り組みによる効果と課題

<p>Objective: The prescription-related inquiry process is being simplified in an increasing number of facilities, wherein doctors and pharmacists discuss ambiguous points concerning prescriptions before creating protocols. For making this process more efficient and further promoting appropriate drug use, the doctors and the Department of Pharmacy of our center discussed the permissible range for prescription change reports and determined the prescription items that pharmacists can change based on their own judgment. We analyzed data related to the simplification of the prescription-related inquiry process to verify the effects and issues associated with simplifying this process. Then, we examined the countermeasures that should be taken as a prescription issuer in response to the issue.</p><p>Methods: The center concluded an agreement with 147 insurance-covered pharmacies in or around Sakai City. We analyzed data related to simplification of the prescription-related process between March 1, 2017, and February 28, 2018.</p><p>Results: Permissible prescription change reports were classified into eight categories. The total number of out-of-hospital prescriptions issued by the center was 94,785. Among the 147 insurance-covered pharmacies under the agreement, 79 (53.7%) reported prescription changes by fax. In total, 895 prescription changes were reported. The number of reports belonging to each category was as follows: change of dosage/additional descriptions: 312 (33.1%); change to other brands with the same ingredients: 208 (22.0%); and change of the medication duration to reduce unused medications: 168 (17.8%). Calculating based on drug prices, change of the medication duration to reduce unused medications consequently reduced medication costs by 709,452 yen.</p><p>Conclusion: It is thought that the simplification of inquiry will result in shortening the waiting time for patients and reducing the time burden of prescribing doctors and pharmacists. Also, by analyzing the contents of the inquiries, it was evident that improvements could be made to improve efficiency by devising an electronic medical record system, which can help avoid similar reports in the future. Furthermore, regularly reviewing the simplifications will contribute to providing higher quality medical care. Cooperation and information sharing between pharmacy pharmacists and hospital pharmacists are indispensable and vital in advancing side effects and risk aversion, polypharmacy measures, and improvement of adherence.</p>