Safety, trust, and money are uncomfortable bedfellowsBMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5750 (Published 03 November 2015) Cite this as: BMJ 2015;351:h5750
- Stephen Chapman, professor of prescribing and head of medicines optimisation1,
- Therese Curtis, real patient volunteer2
- 1Centre for Medicines Optimisation, School of Pharmacy, Keele University, Staffordshire ST5 5BG, UK
- 2Newcastle under Lyme, Staffordshire, UK
- Correspondence to: S Chapman
Safer prescribing has been an objective for physicians since Hippocrates. Yet medicines, although yielding massive net benefit at the population level, continue to cause harm to a considerable proportion of individual patients. Around 5% of hospital admissions could be associated with inappropriate prescribing.1 2
So what reduces errors? The PINCER trial3 compared simple feedback on prescribing errors with a pharmacist led intervention involving feedback, educational outreach, and dedicated support to GP practices. After six months’ follow-up, patients in the pharmacist led group were significantly less likely to have triggered indicators of unsafe prescribing such as receiving a β blocker if they had asthma or an ACE inhibitor or loop diuretic without appropriate monitoring. In a linked paper, Stocks and colleagues (doi:10.1136/bmj.h5501)4 took this one step further and extrapolated the indicators developed from the PRACTICE study5 to a representative sample of over 500 general practices using the Clinical Practice Research Database.
Within the composite indicators are some uncomfortable figures—in some practices, nearly 20% of patients taking aspirin or clopidogrel …
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