Handwritten Opioid Prescriptions More Prone to Mistakes
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Physicians who write their opioid prescriptions by hand make more mistakes than those who prescribe electronically, say researchers at Johns Hopkins Medicine.
Prescribing by hand leads to a trio of prescribing and processing errors in comparison to those created electronically, a study found.
“Mistakes can be made at any point in the prescribing, transcribing, processing, distribution, use and monitoring of opioids, but research has rarely focused as we have on prescribing at the time of hospital discharge or on written prescriptions prescribed for adults,” says lead author Mark Bicket, M.D., assistant professor of anesthesiology and critical care medicine.
Overall, the researchers found that 92 percent of handwritten prescriptions either failed to meet ideal practice standards, contained such errors as the absence of at least two patient identifiers, or failed to comply with federal opioid prescription rules.
“There are the normal legibility issues you would suspect with a handwritten prescription, but we also commonly found things like missing patient identification information and errors in abbreviations,” Bicket added.
Of the 510 prescriptions studied, 42 percent of prescriptions contained some error, according to the researchers. While both the handwritten prescriptions, which made up 47 percent of the total, and prescriptions created by the electronic health system failed to properly meet the DEA’s standard at the same rate, all prescriptions that violated best practice or did not include at least two patient identifiers were handwritten.
Overall, 89 percent of prescriptions written by hand did not meet “best practice” guidelines or were missing at least two forms of patient identification information. Not a single prescription created by the hospital’s electronic prescribing system showed these errors.
Because the computer prints prescriptions using a template that aligns with “best practices,” the only step the prescriber must do after reviewing the prescription is sign it.
Bicket emphasized that errors in prescriptions rarely result in patients getting the wrong drug or dosage. Other safety measures, such as pharmacists double checking the prescription information, such as the drug name, indication and amount, catch the most important errors.
However, errors in prescriptions increase the risk for mistakes. “What we hope our results do is get more practitioners to adopt electronic prescribing systems because we have a duty to practice in a way that has the lowest chance of harm to our patients,” said Bicket.
In 2016, the Centers for Disease Control and Prevention issued new guidelines meant to reduce the use of opioid drugs to fight chronic pain, citing an “epidemic” of opioid overdoses and abuse.
According to the National Institute on Drug Abuse, the two most widely used opioids include hydrocodone (Vicodin) and oxycodone (Percocet and OxyContin).
The National Institute on Drug Abuse estimated that approximately 2.1 million Americans are addicted to prescription opioid pain relievers. About 467,000 Americans are addicted to heroin, and studies have revealed a strong link between heroin use and the use of opioids.