Identification of an updated set of prescribing-safety indicators for GPs

Rachel Spencer, Brian Bell, Anthony Avery, Gill Gookey, Stephen Campbell

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Medication error is an important contributor to patient morbidity and mortality and is associated with inadequate patient safety measures. However, prescribing-safety tools specifically designed for use in general practice are lacking. Aim: To identify and update a set of prescribing-safety indicators for assessing the safety of prescribing in general practice, and to estimate the risk of harm to patients associated with each indicator. Design and setting: RAND/UCLA consensus development of indicators in UK general practice. Method: Prescribing indicators were identified from a systematic review and previous consensus exercise. The RAND Appropriateness Method was used to further identify and develop the indicators with an electronic-Delphi method used to rate the risk associated with them. Twelve GPs from all the countries of the UK participated in the RAND exercise, with 11 GPs rating risk using the electronic-Delphi approach. Results: Fifty-six prescribing-safety indicators were considered appropriate for inclusion (overall panel median rating of 7–9, with agreement). These indicators cover hazardous prescribing across a range of therapeutic indications, hazardous drug–drug combinations and inadequate laboratory test monitoring. Twenty-three (41%) of these indicators were considered high risk or extreme risk by 80% or more of the participants. Conclusion: This study identified a set of 56 indicators that were considered, by a panel of GPs, to be appropriate for assessing the safety of GP prescribing. Twenty-three of these indicators were considered to be associated with high or extreme risk to patients and should be the focus of efforts to improve patient safety.
Original languageEnglish
Pages (from-to)181-190
Number of pages10
JournalBritish Journal of General Practice
Volume64
Issue number621
DOIs
Publication statusPublished - 2014
Externally publishedYes

Fingerprint

Safety
General Practice
Patient Safety
Consensus
Exercise
Patient Harm
Medication Errors
Morbidity
Mortality
Therapeutics

Cite this

Spencer, Rachel ; Bell, Brian ; Avery, Anthony ; Gookey, Gill ; Campbell, Stephen. / Identification of an updated set of prescribing-safety indicators for GPs. In: British Journal of General Practice. 2014 ; Vol. 64, No. 621. pp. 181-190.
@article{113c8cc3e493447b8e70eaed0da20dee,
title = "Identification of an updated set of prescribing-safety indicators for GPs",
abstract = "Background: Medication error is an important contributor to patient morbidity and mortality and is associated with inadequate patient safety measures. However, prescribing-safety tools specifically designed for use in general practice are lacking. Aim: To identify and update a set of prescribing-safety indicators for assessing the safety of prescribing in general practice, and to estimate the risk of harm to patients associated with each indicator. Design and setting: RAND/UCLA consensus development of indicators in UK general practice. Method: Prescribing indicators were identified from a systematic review and previous consensus exercise. The RAND Appropriateness Method was used to further identify and develop the indicators with an electronic-Delphi method used to rate the risk associated with them. Twelve GPs from all the countries of the UK participated in the RAND exercise, with 11 GPs rating risk using the electronic-Delphi approach. Results: Fifty-six prescribing-safety indicators were considered appropriate for inclusion (overall panel median rating of 7–9, with agreement). These indicators cover hazardous prescribing across a range of therapeutic indications, hazardous drug–drug combinations and inadequate laboratory test monitoring. Twenty-three (41{\%}) of these indicators were considered high risk or extreme risk by 80{\%} or more of the participants. Conclusion: This study identified a set of 56 indicators that were considered, by a panel of GPs, to be appropriate for assessing the safety of GP prescribing. Twenty-three of these indicators were considered to be associated with high or extreme risk to patients and should be the focus of efforts to improve patient safety.",
keywords = "Ambulatory care, Consensus, General practice, Medication errors, Patient safety, Primary health care, Quality indicators",
author = "Rachel Spencer and Brian Bell and Anthony Avery and Gill Gookey and Stephen Campbell",
year = "2014",
doi = "10.3399/bjgp14X677806",
language = "English",
volume = "64",
pages = "181--190",
journal = "Journal of the Royal College of General Practitioners",
issn = "0960-1643",
publisher = "Royal College of General Practitioners",
number = "621",

}

Spencer, R, Bell, B, Avery, A, Gookey, G & Campbell, S 2014, 'Identification of an updated set of prescribing-safety indicators for GPs', British Journal of General Practice, vol. 64, no. 621, pp. 181-190. https://doi.org/10.3399/bjgp14X677806

Identification of an updated set of prescribing-safety indicators for GPs. / Spencer, Rachel; Bell, Brian; Avery, Anthony; Gookey, Gill; Campbell, Stephen.

In: British Journal of General Practice, Vol. 64, No. 621, 2014, p. 181-190.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Identification of an updated set of prescribing-safety indicators for GPs

AU - Spencer, Rachel

AU - Bell, Brian

AU - Avery, Anthony

AU - Gookey, Gill

AU - Campbell, Stephen

PY - 2014

Y1 - 2014

N2 - Background: Medication error is an important contributor to patient morbidity and mortality and is associated with inadequate patient safety measures. However, prescribing-safety tools specifically designed for use in general practice are lacking. Aim: To identify and update a set of prescribing-safety indicators for assessing the safety of prescribing in general practice, and to estimate the risk of harm to patients associated with each indicator. Design and setting: RAND/UCLA consensus development of indicators in UK general practice. Method: Prescribing indicators were identified from a systematic review and previous consensus exercise. The RAND Appropriateness Method was used to further identify and develop the indicators with an electronic-Delphi method used to rate the risk associated with them. Twelve GPs from all the countries of the UK participated in the RAND exercise, with 11 GPs rating risk using the electronic-Delphi approach. Results: Fifty-six prescribing-safety indicators were considered appropriate for inclusion (overall panel median rating of 7–9, with agreement). These indicators cover hazardous prescribing across a range of therapeutic indications, hazardous drug–drug combinations and inadequate laboratory test monitoring. Twenty-three (41%) of these indicators were considered high risk or extreme risk by 80% or more of the participants. Conclusion: This study identified a set of 56 indicators that were considered, by a panel of GPs, to be appropriate for assessing the safety of GP prescribing. Twenty-three of these indicators were considered to be associated with high or extreme risk to patients and should be the focus of efforts to improve patient safety.

AB - Background: Medication error is an important contributor to patient morbidity and mortality and is associated with inadequate patient safety measures. However, prescribing-safety tools specifically designed for use in general practice are lacking. Aim: To identify and update a set of prescribing-safety indicators for assessing the safety of prescribing in general practice, and to estimate the risk of harm to patients associated with each indicator. Design and setting: RAND/UCLA consensus development of indicators in UK general practice. Method: Prescribing indicators were identified from a systematic review and previous consensus exercise. The RAND Appropriateness Method was used to further identify and develop the indicators with an electronic-Delphi method used to rate the risk associated with them. Twelve GPs from all the countries of the UK participated in the RAND exercise, with 11 GPs rating risk using the electronic-Delphi approach. Results: Fifty-six prescribing-safety indicators were considered appropriate for inclusion (overall panel median rating of 7–9, with agreement). These indicators cover hazardous prescribing across a range of therapeutic indications, hazardous drug–drug combinations and inadequate laboratory test monitoring. Twenty-three (41%) of these indicators were considered high risk or extreme risk by 80% or more of the participants. Conclusion: This study identified a set of 56 indicators that were considered, by a panel of GPs, to be appropriate for assessing the safety of GP prescribing. Twenty-three of these indicators were considered to be associated with high or extreme risk to patients and should be the focus of efforts to improve patient safety.

KW - Ambulatory care

KW - Consensus

KW - General practice

KW - Medication errors

KW - Patient safety

KW - Primary health care

KW - Quality indicators

UR - http://www.scopus.com/inward/record.url?scp=84898738606&partnerID=8YFLogxK

UR - http://www.mendeley.com/research/identification-updated-set-prescribingsafety-indicators-gps

U2 - 10.3399/bjgp14X677806

DO - 10.3399/bjgp14X677806

M3 - Article

VL - 64

SP - 181

EP - 190

JO - Journal of the Royal College of General Practitioners

JF - Journal of the Royal College of General Practitioners

SN - 0960-1643

IS - 621

ER -