University of Hertfordshire


  • 906538

    Final published version, 139 KB, PDF document

  • Anthony J. Avery
  • Maisoon Ghaleb
  • Nick Barber
  • Bryony Dean Franklin
  • Sarah J. Armstrong
  • Brian Serumaga
  • S. Dhillon
  • Anette Freyer
  • Rachel Howard
  • Olanrewaju Talabi
  • Rajnikant L. Mehta
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Original languageEnglish
Number of pages11
Pages (from-to)e543-e553
JournalBritish Journal of General Practice
Journal publication dateAug 2013
Publication statusPublished - Aug 2013


Objective To determine the prevalence and nature of prescribing and monitoring errors in general practices in the England.
Design Retrospective case note review of unique medication items prescribed over a 12 month period to a 2% random sample of patients. Mixed effects logistic regression was used to analyse the data.
Setting Fifteen general practices across three primary care trusts in England.
Data sources Examination of 6048 unique prescription items prescribed over the previous 12 months for 1767 patients.
Main outcome measures Prevalence of prescribing and monitoring errors, and severity of errors, using validated definitions.
Results Prescribing or monitoring errors were detected in 4.9% (296/6048) of all prescription items (95% confidence interval 4.4 - 5.5%). The vast majority of errors were of mild to moderate severity, with 0.2% (11/6048) of items having a severe error. After adjusting for covariates, factors associated with an increased risk of prescribing or monitoring errors in patients were: age less than 15 (1.81, 1.15 to 2.85, p=0.010) or greater than 64 years (1.67, 1.03 to 2.71, p=0.037), and higher numbers of unique medication items prescribed (1.16, 1.12 to 1.19, p<0.001). By contrast, women were less likely than men to have a prescribing or monitoring error (0.65, 0.47 to 0.90, p=0.010). At the prescription item level there was an increased risk of prescribing or monitoring errors for medications used in cardiovascular disease; infections; malignant disease and immunosuppression; musculoskeletal conditions; eye, ear nose and oropharynx, and skin conditions.
Conclusion Prescribing and monitoring errors are common in English general practice, although severe errors are unusual. Many factors increase the risk of error. Having identified the most common and important errors, and the factors associated with these, this will help in devising effective strategies for preventing errors in the future.


©British Journal of General Practice. This is the full-length article (published online 29 Jul 2013) of an abridged version published in print. Cite this article as: Br J Gen Pract 2013; DOI: 10.3399/bjgp13X670679. Published under a Creative Commons licence that allows reuse subject only to the use being non-commercial and to the article being fully attributed

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