Repeat prescribing – reducing errors

Abstract

BACKGROUND AND CONTEXT: Prescribing errors account for a significant proportion of overall error in general practice. Repeat prescribing occurs commonly in New Zealand and is a likely cause of error in practice. ASSESSMENT OF PROBLEM: This paper reports on two related aspects of repeat prescribing; an audit of adherence to a repeat prescribing protocol and self-reported repeat prescribing incidents in a network of 97 general practices. RESULTS: The audit of adherence to the repeat prescribing protocol revealed that some issues persist. In particular, prescribing medication outside an approved list and exceeding specified time limits or maximal scripts before clinical review were problematic. Repeat prescribing encompassed a range of departures of process from minor (such as prescription not available on time) to major (wrong medication). Corrective measures highlighted the importance of both the pharmacist and the patient in error detection. STRATEGIES FOR IMPROVEMENT: Repeat prescribing needs to be recognised as a process potentially fraught with error. Effective practice systems, patient involvement and enhanced pharmacy communication are important contributing factors in reducing error. LESSONS: There is need for robust data regarding error rates in prescribing and the impact of changing prescribing protocols on error rates. KEYWORDS: Medication errors; electronic prescribing