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Table 2 Top ten medication related problems in primary carea

From: Identification of priorities for improvement of medication safety in primary care: a PRIORITIZE study

RANK

Highlighted medication related problems in primary care

Total priority score

Breakdown point in the medication process

Contributory factor

1

Incomplete reconciliation of medication during patient ‘hand-overs’ such as admission to and discharge from hospital or emergency department

86.7

Transfer of care

Individual staff

2

Incorrect or insufficient patient education about the use of their medication e.g. how to take bisphosphonate or an inhaler

86.3

Administering

Patient

3

Poor discharge summaries

83.8

Transfer of care

Individual staff

4

Polypharmacy in the elderly

81.3

Monitoring

Patient

5

Patient’s inability to understand or remember information about the daily doses or time of administration

81.3

Administering

Patient

6

Repeat prescribing without proper review, leading to continued use of unnecessary or unsafe medications

80.6

Monitoring

Individual staff

7

Time pressures leading to prescribing errors and extended medication review times

79.2

Prescribing

Work environment

8

Long-term prescribing of non-steroidal anti-inflammatory drugs without reviewing if there is an ongoing need for them

77.9

Prescribing

Individual staff

9

Repeat prescribing of pain-killers including opiates without a regular review of true need or alternatives

77.9

Prescribing

Individual staff

10

Delays in receiving notes when patient changes the practice they are registered with

77.3

Transfer of care

Task design

  1. (Clinicians scored problems using the following criteria: frequency, severity, inequity, economic impact and responsiveness to solution (Table 1). The scoring options were 1 for “yes (e.g. this problem is common)”, 0 for “no (e.g. this problem is uncommon)”, 0.5 for “unsure (e.g. I am unsure if this problem is common)” and blank for “unaware (e.g. I do not know if this problem is common)”. Total Priority score is the mean of the scores for each of the five criteria and could range from 0 to 100. Higher ranked problems received more “Yes” responses for each of the criteria and a higher score)
  2. aAll tables use clinicians’ verbatim statements which were only exceptionally reworded for clarity