Analysis of prescribers' notes in electronic prescriptions in ambulatory practice.

Dhavle AA, Yang Y, Rupp MT, Singh H, Ward-Charlerie S, Ruiz J. JAMA Intern Med. 2016 Mar 7; [Epub ahead of print].

Many ambulatory practices have recently introduced electronic prescribing, which has the potential to improve medication safety. In this large cross-sectional study, researchers analyzed more than 26,000 electronic prescriptions that included free-text notes sent to community pharmacies. Two-thirds of free-text notes contained inappropriate content, despite the availability of a standard data field. Nearly 1 in 5 of these notes included conflicting administration instructions from the designated structured field, creating an important source of potential medication errors. In addition, approximately 5% of notes contained irrelevant information, which may distract or confuse pharmacy staff. The authors outline recommended solutions based on the information most commonly included in prescription free-text notes.