Division of Primary Care, School of Community Health Sciences, University of Nottingham Medical School, Nottingham, UK.
Br J Gen Pract. 2013 Aug;63(613):e543-53. doi: 10.3399/bjgp13X670679.
Relatively little is known about prescribing errors in general practice, or the factors associated with error.
To determine the prevalence and nature of prescribing and monitoring errors in general practices in England.
Retrospective case-note review of unique medication items prescribed over a 12-month period to a 2% random sample of patients. Fifteen general practices across three primary care trusts in England.
A total of 6048 unique prescription items prescribed over the previous 12 months for 1777 patients were examined. The data were analysed by mixed effects logistic regression. The main outcome measures were prevalence of prescribing and monitoring errors, and severity of errors, using validated definitions.
Prescribing and/or monitoring errors were detected in 4.9% (296/6048) of all prescription items (95% confidence interval [CI] = 4.4% to 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, patient-related factors associated with an increased risk of prescribing and/or monitoring errors were: age <15 years (odds ratio [OR] = 1.87, 95% CI = 1.19 to 2.94, P = 0.006) or >64 years (OR = 1.68, 95% CI = 1.04 to 2.73, P = 0.035), and higher numbers of unique medication items prescribed (OR = 1.16, 95% CI = 1.12 to 1.19, P<0.001).
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, strategies to prevent future errors should be developed, based on the study findings.
关于一般实践中的处方错误，或者与错误相关的因素，我们知之甚少。
确定英格兰一般实践中处方和监测错误的发生率和性质。
回顾性病历审查，对英格兰三个初级保健信托机构的 15 家一般实践中，过去 12 个月内为 2%的随机患者样本开出的独特药物项目进行审查。
共审查了过去 12 个月内为 1777 名患者开出的 6048 种独特的处方项目。使用验证过的定义，通过混合效应逻辑回归分析数据。主要结局指标是使用验证过的定义，衡量所有处方项目（95%置信区间 [CI] = 4.4%至 5.5%）中处方和/或监测错误的发生率和错误的严重程度。
在所有处方项目中，发现了 4.9%（296/6048）（95%CI=4.4%至 5.5%）存在处方和/或监测错误。绝大多数错误的严重程度为轻度至中度，其中 0.2%（11/6048）的项目存在严重错误。调整了协变量后，与处方和/或监测错误风险增加相关的患者相关因素为：年龄<15 岁（OR=1.87，95%CI=1.19 至 2.94，P=0.006）或>64 岁（OR=1.68，95%CI=1.04 至 2.73，P=0.035），以及开具的独特药物项目数量较高（OR=1.16，95%CI=1.12 至 1.19，P<0.001）。
在英国一般实践中，处方和监测错误很常见，尽管严重错误并不常见。许多因素增加了出错的风险。根据研究结果，应该制定策略来预防未来的错误，这些策略应基于常见和重要错误以及与这些错误相关的因素。
