Electronic prescribing and prescription design in ophthalmic practice

PURPOSE: Prescription and drug errors are common causes of adverse clinical events, posing a significant risk to safe patient care. Although there has been a movement to increase the use of electronic prescribing, concerns over feasibility suggest that improving the design of written prescriptions to minimize missing information may still be worthwhile. This retrospective cross-sectional study examined the effect on prescription completeness of electronic prescriptions and adding information prompts to written prescriptions. We hypothesized that electronic prescription would be superior to written prescriptions on prescription completeness and the inclusion of information prompts in written prescriptions would result in increased recording of the prompted information.

METHODS: Chi-square analysis was used to examine differences among 50 consecutive electronic discharge prescriptions, 100 consecutive outpatient prescriptions (with prompts for medicine duration but not form, frequency, or laterality), and 100 consecutive day surgery prescriptions (with prompts for form, frequency, and laterality) in the provision of 10 key pieces of information.

RESULTS: Electronic prescriptions resulted in 100% complete information across all domains and more complete information on medicine duration than day surgery prescriptions. Written outpatient prescriptions (with duration prompts but not laterality prompts) were superior in recording duration and inferior in recording laterality than day surgery prescriptions (without duration prompts but with laterality prompts).

CONCLUSIONS: Our results support the use of electronic prescribing. Where written prescribing must be used, our study highlights the importance of including information prompts to minimize missing information and improve patient safety.