Necessary patient data for community pharmacists to assess DOAC prescriptions

Abstract

Introduction: The number of DOAC users is increasing. Prescriptions of DOACs are not always accurate due to prescribing errors, especially in the presence of risk factors. Pharmacists play an important role in detecting and correcting incorrect prescriptions, but they need clinical patient data to do so. Unfortunately, these are not always known. In this study, we want to understand what clinical data are missing on first prescriptions of DOACs, what data pharmacists consider necessary, and what barriers, facilitators and opportunities they see with regard to data availability. Method: This research is a combination of qualitative and quantitative research. 18 pharmacies from the Utrecht region participated and 10 pharmacists were interviewed. Data was collected from the first prescriptions of DOACs by means of registration forms. This could indicate, among other things, what was missing and what information had been requested. The interviews asked about barriers, facilitators and opportunities for data availability and the reason for requesting data was requested. Results: Renal function and indication were retrieved significantly more often if they were missing (P < 0.001; P = 0.001). For prescriptions from the hospital, the data was less often missing than when these came from the GP. The main reason for requesting data was dose control. The main facilitator were the systems for communication, monitoring and sending lab values. The biggest barrier was the poor accessibility of the prescribers. An opportunity was mentioned to improve systems so that they automatically send all the necessary data as soon as it is prescribed. Conclusion: Pharmacists consider it important to have an indication and renal function on a prescription. Duration of use, combination therapy and weight were known less often, possibly because they could be deduced by clinical reasoning. Pharmacists find systems that share data helpful, but would also like to improve them by automatically linking data to prescriptions. This would avoid pharmacists having to contact prescribers, which is often a challenge.