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Patients at risk of general practice prescribing errors

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There are an unacceptably high number of prescribi There are an unacceptably high number of prescribing errors in general practice

Approximately one in 100 patients attending general practice may be prescribed inappropriate medication, a survey published in the BMJ has found.

The study of over a million people attending more than 500 GP surgeries in the UK used prescribing and monitoring indicators to judge the level of prescribing error in the UK. The indicators were defined as ‘prescribing patterns that can increase the risk of harm to the patient and should generally be avoided.’

The report found that approximately 5% of patients at risk triggered at least one prescribing indicator and almost 12% triggered at least one monitoring indicator. The study also found that around one in 250 people given prescriptions in general practice do not receive any monitoring of their medication. ‘These results emphasise the need to give due consideration to the risks of prescribing multiple medications and the importance of regular medication reviews, especially for patients with multiple morbidity,’ the authors commented.

'Increasingly, we need more effective ways of looking after – often elderly - people with multiple conditions so that we achieve the right balance between making sure patients have the medications needed for the best possible quality of life, without running into problems from side-effects and interactions from multiple medications,' Maureen Baker, chief executive of the Royal College of General Practitioners, said.

The study also revealed that older patients, who are more likely to receive multiple repeat prescriptions due to comorbidities, were at the highest risk of inappropriate prescribing. In contrast, younger patients with fewer repeat prescriptions had significantly higher risk of triggering a monitoring indicator.

In an accompanying editorial, published in the BMJ, Stephen Chapman, professor of prescribing and head of medicines optimisation at Keele University, and Therese Curtis, a patient volunteer, called for general practice teams to include a clinical pharmacist to provide specialist knowledge on prescription medicines. They also stated that financial incentives are the wrong way to improve prescribing.

According to the research, prescribing errors in primary care account for around 7% of hospital admissions in the UK, and half of these are thought to be preventable.

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