VCOM Louisiana Research Day Program Book 2024

Clinical Research

Austin Bordelon, OMS-IV; Carrie Baker-Royer, DO, FAAP; Bryan Donald, PharmD; Bailey Book, PharmD; Paige Wilson, OMS-IV VCOM-Louisiana; ULM College of Pharmacy 38 SYNTAX ERROR: VARIATIONS IN VERBAGE BETWEEN PRESCRIBER AND PHARMACIST PRESCRIPTION LABELS FOR PEDIATRIC LIQUID MEDICATIONS

Background: Research has been done to establish best practices for dispensing liquid medications for children in order to ensure proper dosing and prevent adverse events. These best practices include specific labeling, dosing devices, education, and other materials that should accompany a prescription to provide the best chance for correct dosing of liquid medications. Virtually all these best practices apply to actions taken at the pharmacy where medications are dispensed. There is an established list of requirements that must be met for all drug labeling. The style, format, and order of these requirements, however, is not standardized. Pharmacists are allowed to modify prescriptions from prescribers for clarity and patient understanding provided the confines of the original order are met, yet the verbage used by pharmacists is also not standardized. Medication errors are the second most common cause of medication-related emergency department visits in children. Most prescriptions are filled and dispensed at pharmacies, so pharmacy plays an invaluable role in any effort to follow best practices and prevent medication errors. To intervene and assist pharmacies, we first need to identify if a problem exists and characterize that problem. Objective: The goal of this descriptive cross-sectional study is to analyze how prescribers write orders for liquid medications in pediatric populations. The goal of this study is also to review how pharmacists keep or modify these prescriptions before printing their labels. Specific attention will be focused on the use of the verbs “give” and “take” and whether they are used interchangeably. This study intends to serve as a step forward toward pharmacy performance and medication safety for children. The subjects of the study are the pharmacies and their aggregate performance where liquid medications are fulfilled, while the participants of the study are the caregivers of children

who have been prescribed liquid medications. We hypothesize that pharmacists will use the verb “take” instead of the verb “give” on their prescription labels for liquid medications in pediatric populations. Our null hypothesis is that pharmacists will only use the verb “give” on their prescription labels for liquid medication in pediatric populations. Methods: Prescribers were recruited in North Louisiana to serve as a referral base for the study, focusing on pediatricians or prescribers who see mostly children in their regular practice. Caregivers were referred to the study by prescribers at the same time a prescription for a liquid medication is issued for the caregiver’s child. To accept the invitation to enter the study, caregivers contacted the study team per instructions in a letter before picking up their child’s medication from the pharmacy and provided informed consent at their enrollment meeting. During the enrollment meeting, caregivers were instructed on how to use the electronic data capture system to complete a survey. After the meeting, caregivers had to complete the rubric within three days. All data collection occurred through either electron data capture system connected to a protected server or in face-to-face meetings with a member of the research team. Pictures of prescription labels collected from the electronic data capture system were deleted immediately after data processing. Prescribers were awarded a $20 stipend for each caregiver they referred who completed the study. Caregivers who completed the rubric were awarded a $40 stipend as well as an additional $20 stipend for completing a debriefing meeting. Results: Twenty-four participants have completed the study at the time of this abstract submission. No participants in the study have completed a debriefing meeting at the time of this abstract submission. 50% of study participants used a chain-pharmacy;

46% of study participants used an independent pharmacy; and 4% of study participants used a hospital-based pharmacy. The majority of medications prescribed to the children of the participants of the study were antibiotics (54%), followed by antidepressants, antiemetics, and gastric antisecretory drugs (8% each). Five (20.8%) prescriber texts used the verb “take” instead of the verb “give.” 13 (54.17%) prescriber texts did not use a verb at all. Six (25%) of the pharmacy labels used the verb “take” instead of the verb “give.” Of these six, three pharmacy labels copied the prescriber’s text exactly, which also used the verb “take.” The other three pharmacy labels inserted “take,” but the prescriber’s text did not use a verb at all. There were no occurrences of the prescriber using the verb “give” where the pharmacy changed to “take.” Conclusions: Based on collected data, we could fairly reject our null hypothesis. The data shows that pharmacists are making an effort to use correct verbage on their prescription labels demonstrated by correcting prescriber texts and also inserted the correct verb when a verb was not used at all. The results of this study could be used to enhance education for pharmacists regarding pediatric prescriptions for liquid medications and for prescribers to prevent accidental injury from using incorrect grammar. The study did not compare hand-written prescriptions and free-text electronic prescriptions versus auto-populated electronic prescriptions. This may play a role in the syntax or lack of verbs found on the prescriptions in this study. Recruitment for this study was difficult and stagnant in its initiation, resulting in an incredibly small sample size of 24. As this study continues, we hope to see our sample size increase so that we may feel more confident in its results.

55 2024 Via Research Recognition Day