Undergraduates must be proficient in basic prescribing

The recent Audit Commission report A Spoonful of Sugar was grim reading.1 The report suggested that nearly 1100 people died last year in England and Wales as a result of medication errors or adverse reactions to medicines and that the number had increased fivefold in just 10 years. This alarming increase may be an overestimate inflated by changes in defining and reporting causes of death and cannot all be attributed to a true deterioration in prescribing. However, studies elsewhere also hint at high rates, 2 3 although the definitions and data have been questioned.3 The Audit Commission failed to distinguish clearly between medication errors, inevitable adverse reactions, and potentially preventable adverse reactions. Since strategies for minimising each are different, we need data that tell us where problems lie.

There are several reasons why drug errors might have risen (see box). In addition, human error is most likely when inexperienced and overworked staff, in a stressful environment, struggle with unfamiliar …