Examination and Evaluation of Laboratory Data for Display on Out-of-Hospital Prescriptions

Recently, there has been a growing trend for hospitals to display laboratory data on out-of-hospital prescriptions. The display methods and specific laboratory data are independently determined by each hospital. We commenced the display of laboratory data on out-of-hospital prescriptions at Kagoshima University Hospital in January 2018. We identified 16 fixed laboratory data for display considering the components of high-risk drugs specified in package inserts. Moreover, tests were considered mandatory if the sections of “warnings” or “important precautions” mentioned “the need for testing” or if the sections of “contraindications” or “dosage and administration” specified criteria for laboratory data related to “initiation,” “reduction,” or “discontinuation.” In such cases, we identified supplementary laboratory data beyond the fixed 16. Consequently, the laboratory data for 121 (4.0％) of the 2,994 drugs available for out-of-hospital prescriptions were needed for display. We conducted a web-based survey targeting community pharmacists to assess the utilization of the displayed laboratory data. The utilization rate of the laboratory data among the 16 fixed items showed that serum Cre and eGFR were frequently used in prescription audits and clarification inquiries. HbA1c was frequently used for patient counseling, along with AST and ALT to confirm side-effects. For each medication, PT-INR was frequently cited in prescription audits, clarification inquiries, and confirmation of side effects. For medication counseling, TG, T-chol, HDL-chol, and LDL-chol were mentioned frequently. Displaying clinically required laboratory data on out-of-hospital prescriptions in a hybrid manner is considered useful.