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Pharmacy Volume May Exceed Safe Capacity

sharon sanders

Editor-in-Chief & President
The United States health care system is at full capacity now.


Prescription Volume May Exceed Safe Capacity

29 Apr 2007 <INPUT onclick="return printPage()" type=button value="Click to Print">

High workloads for pharmacists increase the potential for medication errors, says a new study by University of Arizona College of Pharmacy researchers published in the May issue of the journal Medical Care.

The study was conducted by a team of researchers led by College of Pharmacy professor Daniel C. Malone, Ph.D., who is also a member of the Arizona Center for Education and Research on Therapeutics at the Critical Path Institute.

Researchers reviewed data submitted to insurance companies from 672 pharmacies in 18 metropolitan regions. The pharmacies filled an average of 18,000 prescriptions from January to March 2003, or 1,375 prescriptions per week. During that time, the average number of potentially harmful drug-drug interactions dispensed by each pharmacy was 32.1.

The pharmacies employed an average of 1.2 pharmacists for each hour the store was open, and each pharmacist filled an average of 14.1 prescriptions per hour. The risk of dispensing potentially harmful combinations of medications that could result in a drug interaction increased by 3 percent for each additional prescription filled per hour.

The study also found that computerized interaction alerts and telephone, Internet, and fax systems - which are intended to decrease pharmacist workload and increase the efficiency of prescription receipt and filling - also were associated with an increase in the number of prescriptions dispensed for medications that could interact.

"It appears that prescription volume is exceeding capacity and that automation and other pharmacy staffing may not sufficiently compensate for the increased pharmacist workload," Malone says. "Additional research is needed to confirm and clarify this study, but our findings are consistent with other reports concerning workload and medication errors. We need to take a closer look at what we can do better in community pharmacies to reduce potentially dangerous interactions between dispensed medicines."

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The study was supported by a grant from the Agency for Healthcare Research and Quality's Centers for Research and Education on Therapeutics (CERTs) program. The mission of the CERTs program is to conduct research and provide education that advances the optimal use of drugs, medical devices, and biological products. The Arizona Center for Education and Research on Therapeutics at The Critical Path Institute is one of 11 national CERTs.

Contact: Ginny Geib
University of Arizona Health Sciences Center
 
Re: Pharmacy Volume May Exceed Safe Capacity

From my reading of the study info, that is only for corporate pharmacies swerving locally and does not even include in-house health care facilities which have even high Rx fill rates for example those at hospitals and clinics. Often these pharmacists are lower paid and required to work under even more demanding and stressful situations with irregular schedules that can result in sleep loss and sleep routine disruptions that also cause for stress and error. These facilities include level 1 trauma centers etc.

Additionally this was not looking at the mega-pharm Rx dispensing centers for mail orders. These individuals are required to do even more Rx script dispensing per hour and the pressure is a real cooker for many. I understand that the turnover rate is very high and that compounds the issues of fatigue and lower experience levels. Originally I understood that the expectation would be retired pharmacists would be most interested in these positions as part time but I understand that is not the case for many situations.

this is looking at pharmacies and their medication interactions, couple this with Rx dispensing error and wow the numbers increase. Should and when a pandemic occur, most RX will most likely be dispensed locally I would imagine when there is meds and the issue of long term RX 60-90 day supplies will be a major issue besides the needs for immediate RX dispensing.

How ever you look at it - its not a pretty picture. We should ALL go and thank our pharmacist and offer to buy them coffee to show our appreciation for all their efforts!
Terrie
 
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