1 in 20 doctor's prescriptions contain errors

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Errors rife on GP scripts

One in 20 prescription items on GP scripts contain an error or inadequate instructions on monitoring the drug, a study commissioned by the UK general practice professional regulator has revealed.

Most of the errors were categorised as oversights rather than mistakes,

such as the GP failing to write down how often a patient should take the medication or the prescription of an incorrect dose.

However around one in every 550 prescription items was judged to contain a serious error, which included prescribing penicillin to a patient with a known allergy to the drug, and failing to ensure a patient on warfarin was being regularly monitored.

The researchers identified seven key factors that increased risk of prescription and monitoring error:

The patient – challenging patient, language issues

The prescriber – lack of training, lack of therapeutic knowledge

The workload – time pressures, interruptions, stress

The team - nurses’ ‘quasi-autonomous role’ which meant GPs were often blindly signing prescriptions

The task – repeat prescribing, blood monitoring

The computer - failure to maintain accurate electronic records

The primary-secondary interface – poor correspondence about medications adn discharge time

One GP interviewed for the study said: “I’ve got all these patients to see and then I’ve got a load of phone calls to make, you’ve got visits to do, then you get a medication query and you’re always in a rush, you’re always stressed. So I don’t think the environment helps at all, I

think there’s a lot on GPs’ minds. I think there’s a real risk that things can get overlooked.”

On the back of the findings the UK General Medical Council (GMC) has recommended a greater role for pharmacists in supporting GPs, better use

of computer systems and extra emphasis on prescribing in GP training.

“GPs are typically very busy, so we have to ensure they can give prescribing the priority it needs. Using effective computer systems to ensure potential errors are flagged and patients are monitored correctly

is very important,” Professor Sir Rubin, Chair of the GMC, said.

Professor Tony Avery of the University of Nottingham’s medical school, who led the research, added: “I’d also encourage doctors to share their experiences of prescribing issues both informally within their practices, and also formally where appropriate through local or national

reporting systems. Prescribing is a skill, and it is one that all doctors should take time to develop and keep up-to-date.”

The study comes as Australia looks to extend prescribing rights to other healthcare professions, such as pharmacists and nurses, which the AMA has opposed on the grounds of safety.

The research is the largest UK study to date on the issue. It looked at

prescriptions from 15 GP practices over a 12- month period covering 1,777 patients.

The PRACtICe study, online report 2012 .

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