A good standard of GP prescribing ? but improvement possible

Dr Maisoon Ghaleb, with Professor Soraya Dhillon and Dr Cinzia Pezzoles, from the University of Hertfordshire’s School of Pharmacy has collaborated in a major study into GP prescribing. While the vast majority of prescriptions written by family doctors are appropriate and effectively monitored, around one in twenty prescriptions contain an error

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Summary

The research, the largest-scale study of its kind, was commissioned by the General Medical Council and was carried out in collaboration with Professor Tony Avery et al from the University of Nottingham, Professor Nick Barber et al from UCL School of Pharmacy, and Dr Rachel Howard from the University of Reading. The study provides an important insight into how often errors in prescribing occur, causes of these errors and how they may be prevented.

A sample of fifteen GP practices across three areas in England found that where there were prescribing or monitoring errors, most were classed as mild or moderate, but around one in every 550 prescription items was judged to contain a serious error. The most common errors were missing information on dosage, prescribing an incorrect dosage, and failing to ensure that patients got necessary monitoring through blood tests.

Errors found

Dr Maisoon Ghaleb from the University said: “There are 990 million prescriptions per year dispensed in England, most of them written out by GPs who are typically very busy. In our investigations, we found a number of factors that are associated with increased risk of prescribing errors. These included the number of medicines a patient was taking, the age of the patient and the type of medicine prescribed. There is a need for further research to improve our understanding of the human factors involved in the occurrences of these errors”

Outcome

The research recommends a greater role for pharmacists in supporting GPs, better use of computer systems and extra emphasis on prescribing in GP training.

The report can be found on the GMC website