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 |