Around 5% patients deemed at risk of script errors in primary care receive an inappropriate prescription and 12% have no record of monitoring within the recommended time period, a UK study suggests.
The study, of over 500 UK general practices, was carried out by the University of Manchester and the University of Nottingham.
Older patients and those receiving multiple repeat prescriptions were at highest risk of an inappropriate script, according to the findings published in the British Medical Journal.
“About 5% of patients at risk were found to have received a potentially inappropriate prescription and about 12% had no record of appropriate monitoring”
The results “emphasise the need to give due consideration to the risks of prescribing multiple drugs and the importance of regular drug reviews, especially for patients with multiple conditions,” said the researchers.
They noted that prescribing errors in primary care can cause considerable harm, with adverse drug events accounting for around 7% of hospital admissions, of which half are judged to be preventable.
The study authors used anonymised patient data to investigate the prevalence and predictors of prescribing safety indicators in UK general practice.
Their findings are based on about one million adult patients registered with 526 general practices across the UK who were deemed potentially at risk of a prescribing or monitoring error – due to a long-term condition or a diagnosis associated with contraindicated prescribing.
The mean list size was 9,410, with 73% of practices in England, 14% in Scotland, 9% in Wales and 4% in Northern Ireland.
Around 5% of patients at risk triggered at least one indicator of a “potentially unsafe” prescription and almost 12% triggered at least one indicator for a lack of required monitoring after prescription.
Overall, 49,927 of 949,552 patients triggered at least one prescribing indicator and 21,501 of 182,721 patients triggered the monitoring indicator.
Older patients and those prescribed multiple repeat drugs were found to have significantly higher risks of triggering a prescribing indicator, whereas younger patients with fewer repeat prescriptions had significantly higher risk of triggering a monitoring indicator.
“Older patients and those receiving multiple repeat prescriptions had the highest risk of triggering a prescribing safety indicator”
The researchers stressed that, although prescribing safety indicators described prescribing patterns that can increase the risk of harm to the patient and should generally be avoided, there will always be exceptions where the indicator is clinically justified.
Nevertheless, they said the high prevalence for certain indicators “emphasises existing prescribing risks and the need for appropriate consideration within primary care, particularly for older patients and those taking multiple drugs”.
The high variation between practices for some indicators also suggested potential for improvement through targeted practice level intervention, they added.