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There were 98,097 prescription errors made by pharmacies in Nova Scotia between Oct. 1, 2010 and June 30, 2017.
Broken down as an average amongst the 301 community pharmacies, that works out to about 326 errors per pharmacy per year.
The numbers are contained in a study published in the medical journal CMAJ Open on Tuesday by a team of researchers led by Certina Ho, lecturer at the University of Toronto’s faculty of pharmacy.
“The most valuable takeaway from this is that the majority of quality related events were intercepted or found before being dispensed to patients,” said Ho.
The study looked at reporting by Nova Scotian pharmacies of errors dating back to when the program began in 2010. It found that of the errors, 82 per cent were caught before the medication reached the patient.
Of those errors not caught, 16,681 resulted in no harm to the patient, 839 resulted in “mild harm” to the patient, 80 in “moderate harm,” seven in “severe harm” and two in death.
The other takeaway Ho recommends Nova Scotians heed is that we’re the only province on which the study could be done because our pharmacies were the first to start collecting the information.
The Nova Scotia College of Pharmacists instituted the requirement to record and report errors to an independent body for the purpose of learning from mistakes.
Saskatchewan became the first province to join suit last December.
College registrar Bev Zwicker cautioned people looking at the numbers to remember that this province’s pharmacies issue 13 million prescriptions annually.
“So that represents about 0.1 per cent of prescriptions dispensed,” said Zwicker.
“Then keep in mind the vast majority of those were caught before they got to patients.”
The purpose of the data collection, she said, is to find areas to improve processes both at the individual pharmacy level and at the broader policy level.
The study also found a wide range of reporting — ranging from just one error reported over seven years to a pharmacy that reported 2,806. Ten per cent of the pharmacies were responsible for 42.7 per cent of the errors reported. They are reported anonymously, so The Chronicle Herald was not able to break the numbers down by pharmacy.
The study’s authors concluded that was most likely a sign of various levels of participation by pharmacies rather than some making more errors than others.
“The most important learning that happens is at the individual pharmacy level when they look at their data and identify weakness in their system and take action,” said Zwicker.
“At the college level we see two main areas for us to focus on — prescription data entry and prevention of adverse drug reaction.”
Just over 58 per cent of the errors happened at the point of order entry.
“So you look at the prescription — the legibility of the handwriting,” said Ho. “As we look forward to electronic prescribing that will eliminate some of these human errors by taking out that middle step of interpretation.”
Electronic prescribing is coming to Nova Scotia, said Zwicker.
The college wants to ensure the system is tied into the existing drug information system — which allows pharmacists anywhere in the province to see all prescriptions issued to a patient.
By tying in the two systems, the pharmacists could also red flag potential side-effects caused by drug interactions.
Going forward, Ho’s team wants to move from crunching numbers to looking at the individual stories behind each error and look for trends.