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Long-term prescribing tops medication error claims, says MDU

11 May 2009

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Long-term medication prescriptions feature most commonly in a review of settled medication error claims against GPs, according to the Medical Defence Union (MDU).

The medicolegal organisation says that while the vast majority of the millions of drugs prescribed in the community are prescribed appropriately, medication errors are still one of the main reasons for settling claims on behalf of its GP members.

In a study of 69 settled medication error claims over a recent two-year period, clinical risk manager Dr Karen Roberts found that just under one-third (21) concerned problems with administering repeat prescriptions of medication such as hypnotics, benzodiazepines and steroids.

Problems reported ranged from the side effects of long-term use, to patients who eventually became addicted to a particular drug.

Dr Roberts explained: “With long-term medication, it’s essential to keep lines of communication between doctors and patients open. For example, GP practices should have a system in place to review patients with chronic conditions to check they are taking the drug correctly and not experiencing any adverse reactions.

“Regular reviews provide an opportunity to carry out an appropriate examination and tests and talk to the patient about their health and medication.”

She added: “In general, breakdowns in communication are a feature in many medication error claims. For this reason, it’s important that doctors ensure that patients understand what they are taking, the risks involved, any side effects and possible harmful interactions with freely available drugs or remedies.”

Common reasons for other settled medication error claims included: the prescription of a wrong or inappropriate drug; dose errors; a failure to prescribe, and administration errors.

The damages and costs awarded to the claimants ranged from more than £1m (for multiple drug prescribing resulting in cardiac arrest and brain damage), to £500 (following the prescription of inappropriate heart medication).

Dr Roberts says practice records should include who initiated the treatment, who signed the repeat prescription and how many prescriptions can be issued before a review.

If an adverse event occurs, she says, the patient should receive an explanation and an apology, if appropriate, after they have received appropriate treatment.