The Royal Pharmaceutical Society of Great Britain (RPSGB) is calling for the installation of a pharmacist in every GP practice in the UK to help reduce prescribing errors, after research commissioned by the General Medical Council found that 5% of GP written scripts contain some sort of mistake.
The GMC’s study looked at 6,048 unique prescription items for 1,777 patients, and found that one in 20 contained either a prescribing or monitoring error, affecting about one in eight patients.
The majority of errors were found to be either mild of moderate in severity, but one in 550 contained an error that was judged to be ‘severe’, the GMC said.
The most common types of prescribing error were ‘incomplete information on the prescription’ (30%), ‘dose/strength errors’ (17.8%), and ‘incorrect timing of doses’ (10.5%), while the most common type of monitoring mistake was ‘failure to request monitoring’ (70%).
Interestingly, differences in the risk of prescribing error were also found among different drug groups. For example, compared to gastrointestinal drugs, there was an increased risk of error with cardiovascular drugs (odds ratio 2.37), infections (2.67), malignant disease and immunosuppression (6.77) and musculoskeletal (6.97).
Various factors were found to have contributed to these errors, including a lack of training in prescribing, distractions, time constraints, and the failure of practices to make the most of IT solutions designed to secure safer prescribing.
The report’s recommendations to tackle the issues include: promoting the use of clinical computer systems; greater prominence on the therapeutic knowledge and skills necessary for safe prescribing during GP training; extra education for newly-qualified doctors; better clinical governance; and promoting adverse events reporting to help wider learning.
In addition, it suggests pharmacists could play a much greater role in helping to “mitigate the occurrence of error”, by reviewing patients with complex medicines regimens at a practice level as well as helping to identify errors at the point of dispensing.
RPSGB call for action
This is something with which the RPSGB strongly agrees. “Prescribing errors are common but the number of mistakes could be reduced by up to 50% if GPs introduced an in-house pharmacist-led support scheme”, said the Society’s president Martin Astbury.
Collaboration between pharmacists and GPs makes care safer, he said, and given that the NHS spends £8.8 billion on medicines prescribed mainly by GPs “we must to more to maximise the benefits of that investment”.
Pharmacists and GPs are already working together to ensure the use of powerful prescription medicines is safe and effective, but the RPSGB says it is calling for “every GP practice to have a pharmacist on the premises dedicated to patient safety” to minimise errors.
Clare Gerada, Chair of Council at the Royal College of General Practitioners, has played down the findings, pointing out that “there are over one million patient consultations in general practice every day across the UK, and this report demonstrates that in 95% of cases GPs prescribe safely and effectively in the best interests of their patients”.
