Article date: February 2011
By: Emma Baker, Adele Pryce Roberts, Kirsty Wilde, Hannah Walton, Sati Suri, Gurvinder Rull, Andrew Webb, in Volume 71, Issue 2, pages 190-198
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT
• 8.9% medication orders written by doctors contain prescribing errors, which are made by all grades of doctor from foundation year 1 to consultant.
• Recommendations to improve prescribing safety include continuing education from medical school to retirement, as well as improvement of NHS systems.
• Priority areas for education in prescribing with potential to have impact on prescribing errors have not previously been identified.
WHAT THIS STUDY ADDS
• This study has identified 100 drugs most commonly prescribed in primary and secondary care and shown that these drugs are those most frequently associated with prescribing errors.
• This core drug list has potential to direct prescribing training for both undergraduate and postgraduate prescribers as part of a national strategy to reduce prescribing errors.
AIM To develop a core list of 100 commonly prescribed drugs to support prescribing education.
METHODS A retrospective analysis of prescribing data from primary care in England (2006 and 2008) and from two London Teaching Hospitals (2007 and 2009) was performed. A survey of prescribing by foundation year 1 (FY1) doctors in 39 NHS Trusts across London was carried out.
RESULTS A core list of 100 commonly prescribed drugs comprising ≥0.1% prescriptions in primary and/or secondary care was developed in 2006/7. The core list remained stable over 2 years. FY1 doctors prescribed 65% drugs on the list at least monthly. Seventy‐six% of FY1 doctors did not regularly prescribe any drugs not on the core list. There was a strong correlation between prescribing frequency (prescriptions for each drug class expressed as percentage of all prescriptions written) and error rate described in the EQUIP study (errors made when prescribing each drug class expressed as a percentage of all errors made), n= 39, r= 0.861, P= 0.000.
CONCLUSIONS Our core drug list identifies drugs that are commonly used and associated with error and is stable over at least 2 years. This list can now be used to develop learning resources and training programmes to improve prescribing of drugs in regular use. Complementary skills required for prescribing less familiar drugs must be developed in parallel. Ongoing research is required to monitor the effect of new training initiatives on prescribing error and patient safety.
DOI: 10.1111/j.1365-2125.2010.03823.x
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