Evaluation of Pharmacy Inquiries in Physician Order Reviews for Medication Safety: A Cross-Sectional Study

Background and Objectives: Despite the effort to prevent drug-related problems (DRPs) in healthcare settings, prescribing errors are common in the medication use process. In a Korean teaching hospital, pharmacists verify prescription orders during their routine order review process and document the details in a homegrown health information system (HIS). The objectives of this study were to identify the annual trends in pharmacy inquiries and to evaluate the prevalence of the inquiries by drug ingredients, including a description of the “pharmacy inquiry” screen in the HIS. Materials and Methods: A retrospective cross-sectional study was conducted to describe pharmacy inquiries related to preventing potential DRPs during order reviews and to evaluate the associated factors for discontinuation of prescription orders on medication among inquiries using data from January 2008 to December 2021. A descriptive analysis was performed using 128,188 inquiries, documented by 245 pharmacists for 14 years. Results: The frequency of inquiry steadily increased annually. The most frequent cause was “inappropriate dose or regimen” (49.1%) and “piperacillin and beta-lactamase inhibitor” was the most mentioned drug ingredient in the inquiries (3.4%). The overall acceptance rate of the pharmacists’ recommendation was 82.4%, and the cause of the highest acceptance was “inappropriate mix solution” (96.5%). Hospitalization and certain inquiry topics were significantly associated with discontinuation of prescription orders on inquired medications by clinicians. Conclusions: The findings indicate that pharmacy inquiries with integrated HIS could resolve inaccuracy during physicians’ order reviews and ensure safe patient care. As a tool for preventing prescribing errors, the pharmacy inquiry data can help maximize consistent improvement and optimize the medication use process in healthcare settings.