Quality-related events reported by community pharmacies in Nova Scotia over a 7-year period: a descriptive analysis

Article Figures & Tables

Table 1:

Pharmacy characteristics

Characteristic	No. (%) of pharmacies n = 301
Type of pharmacy^*
Chain	166 (55.1)
Banner	111 (36.9)
Independent	24 (8.0)
Population served by the pharmacy
< 1000	31 (10.3)
1000–4999	70 (23.3)
5000–49 999	145 (48.2)
50 000–99 999	16 (5.3)
> 100 000	39 (13.0)

↵* Chain pharmacies are typically directed by a corporate office, with respect to its professional programs, marketing, ordering, etc. Banner pharmacies are independently owned pharmacies that are affiliated with a central office; they pay fees for the banner’s benefit in centralized buying, marketing and professional programs. Independent pharmacies are not affiliated with any corporately run chains or banners. The owner of an independent pharmacy has complete control over the business (e.g., ordering and marketing strategies).

Table 2:

Quality-related events reported by patient outcome

Event reached patient	Patient outcome	No. (%)	Harm QRE
No	No error (i.e., near miss)	80 488 (82.0)	No
Yes	No harm	16 681 (17.0)	No
Yes	Mild harm	839 (0.86)	Yes
Yes	Moderate harm	80 (0.1)	Yes
Yes	Severe harm	7 (0.00)	Yes
Yes	Death	2 (0.00)	Yes
Total		98 097 (100)

Table 3:

Total number of QREs, number of harm QREs and proportion of harm QREs for each medication system stage

Stage	No. (%)		% Harm QREs^*
Stage	QREs	Harm QREs^*	% Harm QREs^*
Prescribing	10 658 (9.0)	159 (10.6)	1.5
Prescription order entry	69 856 (58.7)	411 (27.4)	0.6
Prescription preparation/dispensing	34 859 (29.3)	571 (38.1)	1.6
Administration	2167 (1.8)	228 (15.2)	10.5
Monitoring/follow-up	704 (0.6)	90 (6.0)	12.8
Not applicable	743 (0.6)	39 (2.6)	5.2
Total	118 987^† (100)	1498^† (100)	–

Note:QRE = quality related event.
↵* Harm QREs are associated with a patient outcome of mild harm, moderate harm, severe harm or death (Table 2).
↵† The reporter can select multiple options for “Medication System Stages Involved” field; hence the total number of QREs and the number of QREs with harm are greater than those shown in Table 2.

Table 4:

Total number of QREs, number of harm QREs and proportion of harm QREs for each type

Type	No. (%) of QREs	No. (%) of harm QREs^*	Proportion of harm QREs^*, %
Incorrect dose or frequency	25 089 (25.6)	254 (27.4)	1.0
Incorrect quantity	19 619 (20.0)	19 (2.0)	0.1
Incorrect drug	13 951 (14.2)	185 (19.9)	1.3
Incorrect strength or concentration	10 508 (10.7)	187 (20.2)	1.8
Incorrect prescriber	8454 (8.6)	0 (0)	0.0
Incorrect patient	5685 (5.8)	32 (3.4)	0.6
Incorrect duration of treatment	5048 (5.1)	18 (1.9)	0.4
Incorrect dosage form or formulation (including not splitting tablets as per patient’s request)	3281 (3.3)	32 (3.4)	1.0
Omitted medication or dose	1919 (2.0)	58 (6.23	3.0
Incorrect route of administration	1121 (1.1)	7 (0.8)	0.6
Incorrect storage	857 (0.9)	3 (0.3)	0.4
Incorrect third-party billing	803 (0.8)	1 (0.1)	0.1
Drug therapy problem — drug–drug/OTC/natural health product interaction	506 (0.5)	19 (2.0)	3.8
Drug therapy problem — documented allergy	447 (0.5)	31 (3.3)	6.9
Drug therapy problem — contraindication	356 (0.4)	12 (1.3)	3.4
Expired medication	191 (0.2)	9 (1.0)	4.7
Drug therapy problem — adverse drug reaction	188 (0.2)	56 (6.0)	29.8
Drug therapy problem — drug–disease interaction	63 (0.1)	3 (0.3)	4.8
Drug therapy problem — drug–food interaction	11 (0.0)	2 (0.2)	18.2
Total	98 097 (100)	928 (100)	–

Note: OTC = over the counter, QRE = quality-related event.
↵* Harm QREs are associated with a patient outcome of mild harm, moderate harm, severe harm or death (Table 2).