Towards safer drug use in general practice.
A voluntary, anonymous incident-monitoring study was set up to identify and characterize events or circumstances which could have or did harm a patient in general practice. The study included 673 practitioners who made 2582 reports, of which half (n = 1294) involved medication problems. Amongst these reports, 1556 adverse drug events (ADE) were identified. More common in general practice than in hospitals were problems with therapeutic use (26% vs. 8%), and prescribing of contraindicated medications (15% vs. 5%). In the latter group, 64 reports (4%) involved the prescription of a medication to which the patient was known to be allergic, 66 (4%) involved medication for which there was a recognized potential for a drug interaction, and 68 (4%) involved contraindicated medications due to pathophysiological factors. It was estimated that computer-based prescribing with decision support could eliminate at least a third of these problems in general practice. Further studies are needed to develop this and other preventive strategies.
Steven
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ID
Research and Health Promotion, Royal Australian College of General Practitioners, St Peters, SA.
Malpass
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A
Moller
J
J
Runciman
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WB
Helps
S C
SC
D001315:Australia / Q000453:epidemiology; D004358:Drug Therapy / Q000706:statistics & numerical data; D004360:Drug Therapy, Computer-Assisted; D064420:Drug-Related Side Effects and Adverse Reactions; D005194:Family Practice / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology* / Q000517:prevention & control; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D012308:Risk Management; D018571:Sentinel Surveillance