Pharmacist intervention rectifies errors in parenteral nutrition prescriptions in cancer patients

Pharmacists play a significant role in identifying and correcting total parenteral nutrition dosing errors for both micro- and macronutrients at a specialized cancer care hospital, which leads to improvements in total parenteral nutrition-related complications and switches to enteral feeding, results of a study have shown.

The authors conducted an observational study to determine the role of pharmacist in identifying the frequency of errors in total parenteral nutrition prescriptions in cancer patients for 2015 and 2016. They collected data of total parenteral nutrition prescriptions of 71 patients for the last 2 years from the Pharmacy Department of specialized cancer care hospital.

The year 2015 showed a higher frequency of dosing errors and incomplete prescriptions compared to 2016. The frequency of macro- and micronutrients dosing errors was higher in adults (23.4 percent and 66.2 percent) than in paediatric patients (14.6 percent and 46.6 percent).

Illegible prescriptions, on the other hand, were more frequent in 2016 than in 2015 (5.03 percent vs 1.64 percent). However, dose interventions by pharmacists led to improvement in patient’s weight (20 percent) and promoted enteral feeding (42.3 percent).

The most common major complication was hypophosphataemia (39.4 percent), followed by hyperglycaemia (10 percent) and catheter-induced infection (ie, sepsis; 4.2 percent).

“Total parenteral nutrition has a high potential for medical errors because of its complex composition, thus leading to severe complications,” the authors said. “Pharmacist review of the prescriptions reduces the risk of inappropriate prescribing, preparation, and administration of parenteral nutrition.”