Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-05-16T09:57:45.138Z Has data issue: false hasContentIssue false

2 - Safety in prescribing

Published online by Cambridge University Press:  22 January 2010

Molly Courtenay
Affiliation:
University of Surrey
Matt Griffiths
Affiliation:
University of the West of England, Bristol
Get access

Summary

Introduction

This chapter sets out the rationale for improving prescribing safety, namely the high rate of deaths, unnecessary hospital admissions and illness caused by unsafe prescribing; and what practical steps prescribers should take to reduce the risk of issuing an unsafe prescription. The tragedy in Northwick Park in 2006 when healthy volunteers suffered catastrophic consequences, albeit in the first test of a new drug, highlighted how pharmaceuticals need to be treated with caution and respect (Sunthralingham, 2006). However, it is not just new drugs which can be unsafe; drugs which have become established after many years of clinical use can also cause problems (Lasser et al., 2002). For example, after several years of use, a widely used non-steroidal anti-inflammatory drug was found to be associated with an increased risk of myocardial infarction (Solomon et al., 2004).

The first part of this chapter describes why prescribing safety is so important and this is addressed under the following four themes:

  1. (1) Key issues for safe prescribing at the point of care. Theme one explores the safety issues that should be considered by an individual prescriber before issuing a prescription. A key message for prescribers is that they need to have the necessary information to hand at the point of prescribing: an understanding of the patient's wishes; access to a comprehensive medical record; and access to information about the drug they are about to prescribe.

  2. […]

Type
Chapter
Information
Medication Safety
An Essential Guide
, pp. 7 - 24
Publisher: Cambridge University Press
Print publication year: 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aylin, P, Best, N, Bottle, A, Marshall, C. (2003). Following Shipman: a pilot system for monitoring mortality rates in primary care. Lancet, 362(9382),485–91.CrossRefGoogle ScholarPubMed
,British Medical Association (2008). Royal Pharmaceutical Society of Great Britain. British National Formulary (BNF) 56. RPS London, URL: http://www.bnf.org.Google Scholar
Bates, DW. (2005). The Critical Care Safety Study: The incidence and nature of adverse events and serious medical errors in intensive care. Crit Care Med, 33(8), 1694–700.Google Scholar
Bates, DW, Gandhi, TK. (2006). Improving acceptance of computerized prescribing alerts in ambulatory care. Journal of the American Medical Information Association, 13(1), 5–11.Google Scholar
Borgheini, G. (2003). The bioequivalence and therapeutic efficacy of generic versus brand-name psychoactive drugs. Clinical Therapy, 25(6), 1578–92.CrossRefGoogle ScholarPubMed
,Committee on Quality of Health Care in America. (2000). To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press. URL: http://books.nap.edu/catalog/9728.html.Google Scholar
,Committee on Quality of Health Care in America, (2001). Institute of Medicine/ Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press, URL: http://www.nap.edu/catalog.php?record_id=10027.Google Scholar
Lusignan, S. (2007). An educational intervention, involving feedback of routinely collected computer data, to improve cardiovascular disease management in UK primary care. Methods in Information Medicine, 46(1),57–62.Google ScholarPubMed
Lusignan, S. (2008). Prescribing support software recommends more expensive prescriptions. Information Primary Care, 16(1), 61–2.Google ScholarPubMed
Lusignan, S, Pritchard, K, Chan, T. (2002). A knowledge-management model for clinical practice. Journal of Postgraduate Medicine, 48(4), 297–303.Google ScholarPubMed
Lusignan, S. (2003). The National Health Service and the internet. Journal of the Royal Society of Medicine, 96(10), 490–3.CrossRefGoogle ScholarPubMed
Donabedian, A. (1966). Evaluating the quality of medical care. Milbank Memorial Fund Quarterly, 44(3), Suppl, 166–206.CrossRefGoogle ScholarPubMed
Essex, B. (1994). Doctor's Dilemmas and Decisions. London: BMJ Books.Google Scholar
Fullerton, SE. (1984). Parallel imports: a pharmacist's viewpoint. British Medical Journal, (Clinical Research Education), 288(6433), 1778–9.CrossRefGoogle ScholarPubMed
,Food and Drugs Administration (FDA). Electronic Orange Book: Approved drug products with therapeutic equivalence calculations. URL: http://www.fda.gov/cder/ob/
Franklin, BD, O'Grady, K, Donyai, P, Jacklin, A, Barber, N. (2007). The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study. Quality Safety in Health Care, 16(4), 279–84.CrossRefGoogle ScholarPubMed
Gommans, J, McIntosh, P, Bee, S, Allan, W. (2008). Improving the quality of written prescriptions in a general hospital: the influence of 10 years of serial audits and targeted interventions. International Medical Journal, 38(4), 243–8.CrossRefGoogle Scholar
,International Pharmacy Federation (FIP). Good pharmacy practice (GPP) in developing countries. Recommendations for stepwise implementation. URL: http://www.fip.nl/www2/pdf/gpp/GPP_CPS_Report.pdf
Jacobs, S, O'Beirne, M, Derflingher, LP, Vlach, L, Rosser, W, Drummond, N. (2007). Errors and adverse events in family medicine: developing and validating a Canadian taxonomy of errors. Canadian Family Physician, 53(2), 271–6.Google ScholarPubMed
Koppel, R, Leonard, CE, Localio, AR, Cohen, A, Auten, R, Strom, BL. (2008). Identifying and quantifying medication errors: evaluation of rapidly discontinued medication orders submitted to a computerized physician order entry system. Journal of the American Medical Information Association, 15(4), 461–5.CrossRefGoogle ScholarPubMed
Kunac, DL, Reith, DM. (2005). Identification of priorities for medication safety in neonatal intensive care. Drug Safety, 28(3), 251–61.CrossRefGoogle ScholarPubMed
Lasser, KE, Allen, PD, Woolhandler, SJ, Himmelstein, DU, Wolfe, SM, Bor, DH. (2002). Timing of new black box warnings and withdrawals for prescription medications. Journal of the American Medical Association, 287(17), 2215–20.CrossRefGoogle ScholarPubMed
Lasser, KE, Seger, DL, Yu, DTet al. (2006). Adherence to black box warnings for prescription medications in outpatients. Archives of Internal Medicine, 166(3), 338–44.CrossRefGoogle ScholarPubMed
Neighbour, R. (2005). The Inner Consultation, 2nd Edition. Oxford: Radcliffe.Google Scholar
Miller, G. (1956). The magical number seven, plus or minus two: some limits on our capacity for processing information. The Psychological Review, 63, 81–97.CrossRefGoogle ScholarPubMed
Mott, DA, Cline, RR. (2002). Exploring generic drug use behavior: the role of prescribers and pharmacists in the opportunity for generic drug use and generic substitution. Medical Care, 40(8), 662–74.CrossRefGoogle ScholarPubMed
,NICE (2008). Respiratory tract infections –antibiotic prescribing; Prescribing of antibiotics for self-limiting respiratory tract infections in adults and children in primary care. NICE Clinical Guideline 69. London: NICE.Google Scholar
,NPSA (2007). Safety in doses: medication safety incident in the NHS: The fourth report from the Patient Safety Observatory. London:NPSA.Google Scholar
Nuckols, TK, Bell, DS, Liu, H, Paddock, SM, Hilborne, LH. (2007). Rates and types of events reported to established incident reporting systems in two US hospitals. Quality Safety Health Care, 16(3), 164–8.CrossRefGoogle Scholar
Pallás, CR, De-la-Cruz, J, Del-Moral, MT, Lora, D, Malalana, MA. (2008). Improving the quality of medical prescriptions in neonatal units. Neonatology, 93(4), 251–6.CrossRefGoogle ScholarPubMed
Rosser, W, Dovey, S, Bordman, R, White, D, Crighton, E, Drummond, N. (2005). Medical errors in primary care: results of an international study of family practice. Can Fam Physician, 51, 386–7.Google ScholarPubMed
Shaw, A, Lusignan, S, Rowlands, G. (2005). Do primary care professionals work as a team: a qualitative study. Journal of Interprofessional Care, 19(4), 396–405.CrossRefGoogle ScholarPubMed
Smith, DH, Perrin, N, Feldstein, Aet al. (2006). The impact of prescribing safety alerts for elderly persons in an electronic medical record: an interrupted time series evaluation. Archives Internal Medicine, 166(10), 1098–104.CrossRefGoogle Scholar
Solomon, DH, Schneeweiss, S, Glynn, RJet al. (2004). Relationship between selective cyclooxygenase-2 inhibitors and acute myocardial infarction in older adults. Circulation, 109(17), 2068–73.CrossRefGoogle ScholarPubMed
Panoskaltsis, N. (2006). Cytokine storm in a phase 1 trial of the anti-CD28 monoclonal antibody TGN1412. New England Journal of Medicine, 355(10), 1018–28.Google Scholar
Thomsen, , Winterstein, AG, Søndergaard, B, Haugbølle, LS, Melander, A. (2007). Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care. Annals of Pharmacotherapy, 41(9), 1411–26.CrossRefGoogle ScholarPubMed
,World Health Organization, URL: (http://www.who.int/medicines/publications/essentialmedicines/en/

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×