The frequency and nature of prescribing problems by general practitioners in training (REVISiT)

Prescribing errors can cause significant morbidity and occur in about 5% of prescriptions in English general practices.Our aim was to describe the frequency and nature of prescribing problems in a cohort of GPs in training to determine whether they need additional prescribing support.A primary care pharmacist undertook a retrospective review of prescriptions issued between 09/10/2014 and 11/03/2015 by ten GPs in their final year of training from ten practices in England.Pre-existing standards, and expert panel discussion, were used to classify the appropriateness of prescribing. Data were imported into STATA Version 13 to perform descriptive analysis. An individualised report highlighting prescribing errors, suboptimal prescribing, and areas of good practice identified during the review was shared with the GPs in training and their trainers. This report was used to guide discussions during the GP in training's feedback session.A total of 1028 prescription items were reviewed from 643 consultations performed by ten GPs in training. There were 92 prescribing errors (8.9%) and 360 episodes of suboptimal prescribing (35.0%). The most common types of error concerned medication dosages (n=30, 32.6% of errors).Personalised review of prescribing revealed an error rate higher than recorded in a previous similar study mainly comprising GPs who had completed postgraduate training, and a substantially higher rate of suboptimal prescribing. A larger intervention study is now required to evaluate the effectiveness of receiving a personalised review of prescribing, and to assess its impact on patient safety.