Patient Safety Culture in Handling Prescriptions and Interprofessional Collaboration Practices Amongst Community Pharmacists: An Investigative Simulated Patient Study from the United Arab Emirates

Figures & data

Figure 1 Study design of the simulated patient research.

Table 1 DTRP Scenarios Assessed in the Study

DTRP Under Investigation	Patient Details	Prescription	Comment
Wrong dose	Asthma since childhood	MDI. Ventorlin SOS, Fluticasone 100 MCQ 6 puffs 6 times daily. Continue for 3 months	Fluticasone inhaler 6 puffs 6 times a day for 3 months was the wrong dose
Wrong dosage form	Redness in right eye for 2 days	Tab. Ibuprofen 400mg TID ×3 days	Redness in the eye was wrongly treated with ibuprofen tablets
Wrong duration	Cough with sputum for 3 days	Tab. Augmentin 1g TID ×21 days. Follow up after 3 weeks	Prescription included an antibiotic (Augmentin) for 21 days
Wrong indication	Diarrhea for 2 days	Take ORS ×2 Days Tab. Metoclopramide 10mg SOS, Tab. Bisacodyl 10mg ×6 days	The prescription included ORS, Metoclopramide and Bisacodyl for a patient with diarrhea
Therapy not indicated (no indication for drug)	Hypertension for the past 6 years	Rx. Tab clopidogrel 75mg OD ×2 months, Tab. Atorvastatin 20mg OD ×2 months	Hypertensive patient was given Tab. Atorvastatin and Clopidogrel which were not needed.

Table 2 Identification of DTRPs by the Pharmacists

DTRP	Identifying DTRP	n	%
Wrong dose	Identified	5	50
	Failed to identify	5	50
Wrong dosage form	Identified	4	40
	Failed to identify	6	60
Wrong duration	Identified	5	50
	Failed to identify	5	50
Wrong indication	Identified	8	80
	Failed to identify	2	20
Therapy not indicated	Identified	0	0
	Failed to identify	10	100

Note: Upon identification of the DTRPs, the community pharmacists raised concerns about the presence of DTRPs in all the identified prescriptions.

Table 3 Action Taken by Pharmacists for the DTRPs

DTRP	Action Taken	n	%
Wrong dose	Dispensed	6	60
	Did not notice	3	30
	Refused	1	10
Wrong dosage form	Dispensed	8	80
	Did not notice	0	0
	Refused	2	20
Wrong duration	Dispensed	6	60
	Did not notice	0	0
	Refused	4	40
Wrong indication	Dispensed	1	10
	Did not notice	0	0
	Refused	9	90
Therapy not indicated	Dispensed	10	100
	Did not notice	0	0
	Refused	0	0

Table 4 Counseling Standards Maintained by the Pharmacists with Prescriptions Containing DTRPs

DTRP	Counseling Standard	n	%
Wrong dose	Low	8	80
	Average	0	0
	Good	2	20
Wrong dosage form	Low	3	30
	Average	4	40
	Good	3	30
Wrong duration	Low	3	30
	Average	5	50
	Good	2	20
Wrong indication	Low	1	10
	Average	3	30
	Good	6	60
Therapy not indicated	Low	4	40
	Average	5	50
	Good	1	10

Table 5 Time Spent by Pharmacists in Dispensing the Prescriptions with DTRPs

DTRP	Dispensing Time	n	%
Wrong dose	Less than a minute	6	60
	More than a minute	4	40
Wrong dosage form	Less than a minute	8	80
	More than a minute	2	20
Wrong duration	Less than a minute	8	80
	More than a minute	2	20
Wrong indication	Less than a minute	0	0
	More than a minute	10	100
Therapy not indicated	Less than a minute	4	40
	More than a minute	6	60

Table 6 Physician Visit Suggestion by the Pharmacists

DTRP	Suggested to Visit Physician	n	%
Wrong dose	Yes	5	50
	No	5	50
Wrong dosage form	Yes	2	20
	No	8	80
Wrong duration	Yes	5	50
	No	5	50
Wrong indication	Yes	7	70
	No	3	30
Therapy not indicated	Yes	0	0
	No	10	100