Dispensing errors and counseling quality in 100 pharmacies

Objective: To evaluate the dispensing accuracy and counseling provided in community chain pharmacies. Design: Cross-sectional study. Setting: Community chain pharmacies in large metropolitan areas of Florida, Georgia, New Jersey, and New York. Participants: Community chain pharmacies and trained shoppers. Interventions: Trained shoppers presented a new prescription order for one of five study drugs to each randomly selected pharmacy, and all encounters with pharmacy staff were recorded on video by ABC News 20/20 staff using hidden cameras. Main outcome measures: Dispensing errors on prescriptions for selected medications were the indicator of prescription dispensing accuracy. Frequency of verbal counseling and information categories discussed or included in written information were used to assess the quality of counseling. Results: Of 100 prescriptions dispensed, 22 had one or more deviation from the physician's written order, for a 22% dispensing error rate. Three of the errors were judged to be potentially harmful when dispensed to a typical patient requiring these therapies. A total of 43 shoppers (43%) received verbal counseling, including 16 cases in which the shopper prompted counseling. All shoppers received written information with their prescription, covering an average of 90% of the required topics. Some 68% of the warfarin shoppers purchased aspirin without the pharmacist verbally warning about taking the drugs simultaneously. Conclusion: The dispensing error rate of more than one in five prescriptions is similar to the rate found in a similar study conducted 14 years ago, but counseling frequency has decreased significantly during the period.