A study of over 500 UK general practices has found that around one in 100 patients is at risk from receiving an “inappropriate” prescription, and around one in 250 is not being monitored correctly.
The BMJ-published study, by researchers at Manchester University and the University of Nottingham, also showed that older patients and those with multiple repeat prescriptions were at highest risk.
Using anonymised patient data from the Clinical Practice Research Datalink the team looked at the prevalence and predictors of prescribing safety indicators in UK general practice.
The findings, based on about one million adult patients, showed that around 5% of patients at risk triggered at least one prescribing indicator and almost 12% triggered at least one monitoring indicator.
Older patients and those with multiple repeat scripts had significantly higher risks of triggering a prescribing indicator, while younger patients with fewer repeat prescriptions had significantly higher risks of triggering a monitoring indicator.
The findings “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,” the researchers note.
Also, the study uncovered “high variation” among practices for some indicators, which “suggests potential for improvement through targeted practice level intervention”, they stress.
Earlier this week Pharmacy Voice also called for regular, six-monthly medicines use reviews for elderly patients, after a study found that more than half of patients aged over 75 years are taking too many medicines.
Prescribing errors can pose a significant risk to patient health; around 7% of hospital admissions are down to adverse drug events, but around half of these are thought to be preventable.
Prescribing a ‘core skill’
“Prescribing is a core skill for GPs. We follow strict and robust monitoring systems and patients can be assured that their family doctor will prescribe medication only when absolutely necessary and alternative treatments have been explored,” said Maureen Baker, chair of the Royal College of General Practitioners.
But “increasingly, we need more effective ways of looking after – often elderly – people with multiple conditions so that we achieve the right balance between making sure patients have the medications needed for the best possible quality of life, without running into problems from side-effects and interactions from multiple medications”.
She hopes that having pharmacists working as part of the practice team will help practices to manage medications most effectively, and also notes that the RCGP is also supporting practices to enable patients to see their medical records online.