Missed drug therapy alerts as a consequence of incomplete electronic patient records in Dutch community pharmacy

Background and Objective: Complete and up-to-date medical and pharmaceutical information in the electronic patient record (EPR) is a prerequisite for comprehensive risk management in community pharmacy. Our aim was to analyse which information is missing in the EPR and which drug therapy alerts will therefore fail to appear. Setting and Method: Pharmacy master students selected patients who were dispensed a prescription drug and enlisted for>3 months in the participating pharmacies. The patients received a questionnaire in which they were asked to verify their medication history including contra-indications and intolerabilities, and to provide additional relevant patient information. For each enrolled patient, the students collected all relevant information from the EPR. Main outcome measures: Self-reported data from the patient were compared with data retrieved from the EPR. Missed information in the EPR was evaluated based on national professional guidelines. Results: Questionnaires were received from 442 of 660 selected patients. Prescription drugs were missing in the EPR of 14 % of the 442 patients, non-prescription drugs in 44 %, diseases in 83 % and intolerabilities in 16 %. In over one third of patients drug therapy alerts failed to appear due to missing information: drug-disease interactions in 34 % of the patients, duplicate medications in 4 %, drug-drug interactions in 4 %, drug intolerabilities in 2 %. Appropriate management did not take place in 375 drug-disease interactions and 27 drug-drug interactions. Conclusions: Relevant patient information was frequently missing in the EPRs. The non-appearance of drug therapy alerts may have had clinical consequences for patients. Pharmacists should ensure that EPRs are complete and up-to-date.