OBJECTIVES: Ontario pharmacists have been granted the authority to prescribe medications for smoking cessation in their expanded scope of practice. To help pharmacists minimize errors when prescribing for smoking cessation, medication incidents involving Varenicline and Bupropion must be examined. The objective of this project was to identify areas of vulnerabilities when prescribing and dispensing of smoking cessation therapies.,METHODS: A qualitative, multi-incident analysis was conducted using anonymous incident reports submitted to the Institute for Safe Medication Practices Canada Community Pharmacy Incident Reporting Program. Medication incidents involving Varenicline and Bupropion were included in the analysis.,RESULTS: A total of 360 incidents were analyzed. Our findings were divided into two main themes according to the medication therapies: (1) Varenicline and (2) Bupropion. The main themes were then further divided into subthemes, comprising of prescription instructions, quantity of tablets, and drug formulation. Safety interventions include separation of instructions for starter pack and continuation packs, implementation of preprinted order forms and independent double checks in the pharmacy workflow, and verification of the medication with patients during patient counselling.,CONCLUSIONS: As more patients access smoking cessation therapies, there are more opportunities for pharmacist-patient interactions. With pharmacists' expanded scope of practice, there is also a new potential for near misses and incidents involving prescribing errors in the pharmacy. Through shared learning of existing smoking cessation medication incidents from this project, pharmacists will be more prepared and aware of safe medication use when executing their expanded scopes.
OBJECTIVES: Ontario pharmacists have been granted the authority to prescribe medications for smoking cessation in their expanded scope of practice. To help pharmacists minimize errors when prescribing for smoking cessation, medication incidents involving Varenicline and Bupropion must be examined. The objective of this project was to identify areas of vulnerabilities when prescribing and dispensing of smoking cessation therapies.,METHODS: A qualitative, multi-incident analysis was conducted using anonymous incident reports submitted to the Institute for Safe Medication Practices Canada Community Pharmacy Incident Reporting Program. Medication incidents involving Varenicline and Bupropion were included in the analysis.,RESULTS: A total of 360 incidents were analyzed. Our findings were divided into two main themes according to the medication therapies: (1) Varenicline and (2) Bupropion. The main themes were then further divided into subthemes, comprising of prescription instructions, quantity of tablets, and drug formulation. Safety interventions include separation of instructions for starter pack and continuation packs, implementation of preprinted order forms and independent double checks in the pharmacy workflow, and verification of the medication with patients during patient counselling.,CONCLUSIONS: As more patients access smoking cessation therapies, there are more opportunities for pharmacist-patient interactions. With pharmacists' expanded scope of practice, there is also a new potential for near misses and incidents involving prescribing errors in the pharmacy. Through shared learning of existing smoking cessation medication incidents from this project, pharmacists will be more prepared and aware of safe medication use when executing their expanded scopes.
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