Wednesday, May 02, 2012

Millions of GP prescriptions contain dangerous errors: research

The Telegraph 2 May 2012 by Rebecca Smith

Almost two million GP prescriptions contain potentially life threatening errors with mistakes in those given to one in five patients, research by the General Medical Council has found. 

Errors including wrong dosages, lack of instructions and insufficient monitoring of patients on dangerous drugs were 'common'.

Elderly and young children are twice as likely to be given a prescription with an error because the over 75s are often on several drugs and the correct dose can be difficult to calculate in youngsters because it is usually based on body weight, the study found.
Time pressures during GP consultations are thought to be to blame along with complex computer software that makes it easy to select the wrong drug or incorrect dose from drop-down menus and frequent distractions and interruptions.

Several GPs said practice nurses who are responsible for managing some long-term conditions often asked them to sign prescriptions without seeing the patient and this made them 'uneasy' and also interrupted them during clinic meaning they may make mistakes themselves.

Also repeat prescriptions were often issued without questioning if the patient still needed the medicine, or if superior ones were available and results from separate clinics were often not relayed to the GP meaning drug doses were not adjusted, it was found.

Human error and not a lack of understanding or knowledge was behind most mistakes, the study said.
Extending the average GP consultation from 13 minutes to 15 and better training in safety would help, lead author, Prof Tony Avery, of Nottingham University, said.

Pharmacists and GP receptionists can also help by carrying out medicine reviews and checking monitoring arrangements.

Errors classed as severe included, a 62-year-old woman with a documented allergy to penicillin who was prescribed flucloxacillin, a similar drug, and elderly patients prescribed blood thinner warfarin, who should have been closely monitored but who were not tested for two years.

Moderate errors included a four-year-old girl with a stomach upset who was prescribed a drug that should be used 'with caution' in children.

Minor errors found in the study included a one-year-old girl who was given two prescriptions for antibiotics in the same consultation but with different doses stipulated.

Failing to request that the patient be monitored was the most common serious error followed by prescribing a drug the patient was allergic to.

Almost all of the serious errors related to one drug, warfarin, which has been used as rat poison. It is prescribed to thin the blood in people at risk of blood clots. It must be carefully monitored because it interacts with other drugs and some foods and patients with levels too high can suffer potentially life threatening stomach bleeds.

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