GP prescribing meets a good standard overall, but there are a worrying amount of errors, concludes a large national study published today by the General Medical Council (GMC).
The GMC report The PRACtICe Study (PRevalence And Causes of prescrIbing errors in general practiCe) found that most prescriptions written by GPs were appropriate and effectively monitored, but there were around 1 in 20 that contained an error.
Researchers led by the University of Nottingham looking at a sample of 15 GP practices from three areas in England and found that where there were errors, most were classed as mild or moderate.
However, around 1 in every 550 prescription items was judged to contain a serious error.
A total of 1,777 patients were included in the study and were representative of the population of England.
The medical records of these patients were investigated to identify potential prescribing or monitoring errors associated with over 6,000 prescription items that had been issued in the previous 12 months and their severity.
The researchers also interviewed 34 prescribers and explored the causes of 70 of the medication problems that they had found, including the most serious errors.
Overall, the researchers found 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.
Authors of the research, commissioned by the GMC, said improvements could be made and they recommended a greater role for pharmacists in supporting GPs, better use of computer systems and extra emphasis on prescribing in GP training.
A lack of time spent with patients was often a problem and the report also recommends that GPs should extend their consultation time for high-risk or complex patients to allow for a better quality of care provided.
Professor Tony Avery of University of Nottingham’s medical school, who led the research, said: “Few prescriptions were associated with significant risks to patients but it’s important that we do everything we can to avoid all errors.
“GPs must ensure they have ongoing training in prescribing, and practices should ensure they have safe and effective systems in place for repeat prescribing and monitoring.”
Professor Sir Peter Rubin, GMC chair, said: “GPs are typically very busy, so we have to ensure they can give prescribing the priority it needs.
“We will be leading discussions with relevant organisations, including the RCGP, the CQC, and the chief pharmacist in the Department of Health, to ensure that our findings are translated into actions that help protect patients.”
The RCGP defended GPs performance in this area and its chair of council Dr Clare Gerada said that of the more than one million patient consultations in UK general practice every day, GPs prescribed safely and effectively in 95% of cases.
“GPs strive to keep their prescribing skills up to date to provide the safest possible patient care, but any error in GP prescribing is regrettable and is taken very seriously by GPs and their teams,” said Dr Gerada.
“Prescribing is a core skill for GPs and, in the main, standards are extremely high. Patients can be reassured that many processes within practices are already working extremely well and safely, while advances in technology, regular robust monitoring systems and efficient team working are making it safer and even more effective.”