Rural Telepharmacies Do Not Have Higher Error Rates

Although the rate of prescription errors is relatively uniform at supervising and remote telepharmacy sites, the types of and solutions to errors differ between these settings, researchers from the University of North Dakota determined.

The study, published in the September and October 2012 editions of the Journal of the American Pharmacists Association, evaluated medication error rates and types at traditional community pharmacies and the rural telepharmacy sites they supervise. The study included 14 rural sites that typically served communities with fewer than 1500 residents, and were staffed by 1 to 2 pharmacy technicians who processed 40 to 100 scripts per day. Researchers also studied 10 traditional, central pharmacy sites serving areas with 1500 to 5000 residents, with a staff of 1 to 3 pharmacists filling between 75 and 250 prescriptions per day.

Researchers scrutinized 2 types of quality-related medication events: a “near miss,” where the mistake is caught before the medications get to a patient, and “errors,” which are discovered after the medication reaches the patient.

At the remote sites surveyed, 47,078 prescriptions were filled, with 631 quality-related medication events. At the central pharmacy sites, 62,480 prescriptions were filled, with 895 quality-related medication events. Pharmacy staff at the central sites noticed 723 medication errors before the medication went out, whereas 553 medication errors were detected at the remote sites prior to releasing the medication. Medication errors detected after release to patients totaled 78 instances at remote sites and 172 instances at central sites, for rates of 0.17% and 0.28%, respectively.

Errors included filling the incorrect drug or medication strength, providing incorrect directions, refills, or quantity, and other errors. Remote sites had a higher percentage of incorrect directions (18.9%) than central sites (13.4%), although other errors did not have statistically significant differences. At the pharmacies relying on telepharmacy services, pharmacists were more likely to find medication errors during a final medication check than at the supervising sites.