There are several limitations to this study; this was a
retrospective, single-center study. The procedure to collect
the data relied solely on prescriptions sent to the problem
queue. There are instances in which a pharmacist is able to
contact the prescriber and make changes to a prescription
without sending the prescription to the problem queue. This
example suggests that the data collected is likely an underestimation
of the true number of prescriptions requiring an
intervention.
An additional limitation to this study is that the majority of
prescribers were house staff physicians from an academic
teaching hospital. In this setting, there is a learning curve
experienced by new prescribers in training. As a result, the
error rate of prescriptions in this study may be higher than at
other outpatient pharmacies. This may be due to the learning
curve experienced by new prescribers in training. Prescribers
may have also been more inclined to accept pharmacist interventions
in the environment of a teaching hospital. In
addition, the Johns Hopkins Outpatient Pharmacy at the
Arcade receives more pediatric and high-alert medications
compared with other community pharmacies, on the basis of
its location within an integrated health system.
As mentioned previously, a lack of a control group in
this study limits the conclusions that can be taken from
this study. Without a control group, patient demographics
are purely descriptive and leave opportunity for follow-up
and additional studies to determine what ages and weights
of patients are more susceptible to weight-based dosing
errors.