[1,18,19] Integration of electronic prescribing in hospital, comm

[1,18,19] Integration of electronic prescribing in hospital, community and aged-care settings has been trialled, and national implementation, in line with the development

BI 6727 molecular weight of national electronic health records, is currently under review.[20] However, the implementation of electronic prescribing requires training for healthcare staff, funding, technological resources and compatibility with the existing medication recording system,[1,19,20] limiting the potential for expansion in rural areas. Relevant exploratory research for implementation in rural areas is lacking. It is crucial to review medication orders or prescriptions for compliance with legislative or PBS requirements and clinical appropriateness prior to supply or administration of the medication, a task commonly undertaken by pharmacists. The Regulation specifies that pharmacists must follow Quality PF-02341066 purchase Standards during dispensing of medications to consumers (section 4A).[5] The standards that apply are the Pharmaceutical Society of Australia (PSA) Professional Practice Standards.[21] Specifically, the pharmacist should review the medication order by considering the patient’s medication history, drug interactions or appropriateness of dosing regimen when dispensing the prescribed medication.[2,21,22] Studies have shown that the support from a pharmacist in reviewing prescribing decisions is perceived

by prescribers as valuable.[19,23–25] Electronic transfer of prescriptions (under development

in Australia) has integrated computer-based SDHB clinical decision-support systems for checking of the patient’s medication history for interactions, allergies and duplicate ordering, to enhance appropriate prescribing and patient safety.[1,8,19,26] Although studies exploring such systems have been limited to certain settings or institutions,[1,26] the implementation of nationwide electronic health records will allow a consistent and complete set of patients’ medication records to improve provision of healthcare.[20] While the benefits of support systems in assisting with prescribing have been reported, some of the shortcomings identified in the literature were blocking features for privacy, excessive or inappropriate alerting systems and variability or inconsistencies across products.[1,19,20] Although research and evidence is lacking in terms of the superiority of computerised systems as opposed to pharmacotherapeutic knowledge of an actual healthcare provider, such as a pharmacist, adjunct use of such support systems has the potential to improve the process of reviewing medication orders. No reports were identified involving non-pharmacists’ review of prescribing decisions in a rural setting, although nursing staff were reported to perform occasional clarification of medication orders.

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