Benefit of targeted, pharmacist-led education for junior doctors in reducing prescription writing errors – a controlled trial

Background: Prescribing errors are common and a known cause of adverse patient outcomes. Junior doctors are responsible for the majority of prescribing, and may benefit from educational interventions. Aim: To assess the effect of (1) targeted pharmacist-led feedback and education, and (2) an e-learning prescribing module, on prescription writing error rates by junior doctors in the inpatient medical setting. Methods: We undertook a cluster randomised trial in 2014 involving 16 prescribers in four general medical units of an Australian tertiary hospital. One unit was randomised to prescribing feedback and targeted education by a clinical pharmacist; another unit was randomised to an e-learning intervention on safe prescribing; and two units were randomised to no intervention. Data were collected via daily audit of paper medication charts. A prescription writing error was deemed to have occurred if patient or prescriber details were incomplete, or if a medication order was illegible, incomplete or incorrect. Statistical analysis was by Chi-squared comparison of each unit's error rate pre-intervention to post-intervention. Results: Prescription writing errors were significantly reduced in the pharmacist education group, from 0.58 errors/total orders pre-intervention to 0.37 errors/total orders post-intervention (p < 0.001). Conversely, an increase in the error rate of the control group was observed from 0.49 to 0.59 errors/total orders (p < 0.001), and to a lesser extent in the e-learning group from 0.58 to 0.63 errors/total orders (p = 0.025). Conclusions: Regular and targeted pharmacist feedback and education is effective at reducing prescription writing errors, while the effect of e-learning tools remains unclear.