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Med Care. 2009 Mar;47(3):370-3. doi: 10.1097/MLR.0b013e31818af91a.

Variability in pharmacy interpretations of physician prescriptions.

Author information

  • 1, Center for Communication in Healthcare, Institute for Healthcare Studies and Division of General Internal Medicine, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, USA. mswolf@northwestern.edu

Abstract

BACKGROUND:

The clarity of prescription drug instructions is a health literacy and medication safety concern.

OBJECTIVE:

To assess the variability of pharmacy interpretations of physician prescriptions.

DESIGN:

Identically written prescriptions for 4 common medications (atorvastatin, alendronate, trimethoprim/sulfamethoxazole, ibuprofen) were filled in 6 pharmacies (2 largest chains, 2 grocery stores, 2 independents) in 4 cities (Boston, Chicago, Los Angeles, Austin).

MEASUREMENT:

Components of the instruction were coded as dose, frequency, administration route, timing, indication, and auxiliary instructions.

RESULTS:

In all, 85 labels were evaluated. Dose frequency was omitted on 6% of instructions ("take 1 tablet for cholesterol"). Timing was explicitly stated on 2% of instructions ("in the morning"). All prescriptions included indications; pharmacies transcribed these onto 38% of labels. The prescription for alendronate stated not to lie down for at least 30 minutes after taking; this was transcribed with 50% of instructions. Reading difficulty was above recommended levels for 46% of instructions; with 14% greater than a high school level.

CONCLUSIONS:

Efforts are needed to ensure patients receive clear, consistent information supporting safe medication use.

PMID:
19194338
[PubMed - indexed for MEDLINE]
PMCID:
PMC2680452
Free PMC Article
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