Investigating the prevalence and causes of prescribing errors in general practice : the PRACtICe Study
Abstract
Aim: To determine the prevalence and nature of prescribing errors in general practice; to explore the causes, and to identify defences against error.Methods: 1) Systematic reviews; 2) Retrospective review of unique medication items prescribed over a 12 month period to a 2% sample of patients from 15 general practices in England; 3) Interviews with 34 prescribers regarding 70 potential errors; 15 root cause analyses, and six focus groups involving 46 primary health care team members Results:The study involved examination of 6,048 unique prescription items for 1,777 patients.Prescribing or monitoring errors were detected for one in eight patients, involving around one in 20 of all prescription items.The vast majority of the errors were of mild to moderate severity, with one in 550 items being associated with a severe error.The following factors were associated with increased risk of prescribing or monitoring errors: male gender, age less than 15 years or greater than 64 years, number of unique medication items prescribed, and being prescribed preparations in the following therapeutic areas: cardiovascular, infections, malignant disease and immunosuppression, musculoskeletal, eye, ENT and skin.Prescribing or monitoring errors were not associated with the grade of GP or whether prescriptions were issued as acute or repeat items.A wide range of underlying causes of error were identified relating to the prescriber, patient, the team, the working environment, the task, the computer…
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