Format

Send to

Choose Destination
BMJ Open. 2017 Jul 26;7(7):e013658. doi: 10.1136/bmjopen-2016-013658.

Medication incidents in primary care medicine: a prospective study in the Swiss Sentinel Surveillance Network (Sentinella).

Author information

1
Institute of PrimaryCare, University of Zurich, Zurich, Switzerland.
2
Swiss Patient Safety, Zurich, Switzerland.
3
Institute of Family Medicine, University of Lausanne, Lausanne, Switzerland.
4
Sentinel Surveillance Network, Swiss Federal Office of Public Health, Bern, Switzerland.
5
Epidemiology,Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.
6
Division of Science, National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland.
7
Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland.
8
Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland

Abstract

OBJECTIVES:

To describe the type, frequency, seasonal and regional distribution of medication incidents in primary care in Switzerland and to elucidate possible risk factors for medication incidents.

DESIGN:

Prospective surveillance study.

SETTING:

Swiss primary healthcare, Swiss Sentinel Surveillance Network.

PARTICIPANTS:

Patients with drug treatment who experienced any erroneous event related to the medication process and interfering with normal treatment course, as judged by their physician. The 180 physicians in the study were general practitioners or paediatricians participating in the Swiss Federal Sentinel reporting system in 2015.

OUTCOMES:

Primary: medication incidents; secondary: potential risk factors like age, gender, polymedication, morbidity, care-dependency, previous hospitalisation.

RESULTS:

The mean rates of detected medication incidents were 2.07 per general practitioner per year (46.5 per 1 00 000 contacts) and 0.15 per paediatrician per year (2.8 per 1 00 000 contacts), respectively. The following factors were associated with medication incidents (OR, 95% CI): higher age 1.004 per year (1.001; 1.006), care by community nurse 1.458 (1.025; 2.073) and care by an institution 1.802 (1.399; 2.323), chronic conditions 1.052 (1.029; 1.075) per condition, medications 1.052 (1.030; 1.074) per medication, as well as Thurgau Morbidity Index for stage 4: 1.292 (1.004; 1.662), stage 5: 1.420 (1.078; 1.868) and stage 6: 1.680 (1.178; 2.396), respectively. Most cases were linked to an incorrect dosage for a given patient, while prescription of an erroneous medication was the second most common error.

CONCLUSIONS:

Medication incidents are common in adult primary care, whereas they rarely occur in paediatrics. Older and multimorbid patients are at a particularly high risk for medication incidents. Reasons for medication incidents are diverse but often seem to be linked to communication problems.

KEYWORDS:

medication errors.; patient safety; pharmaceutical preparations

PMID:
28751484
PMCID:
PMC5642752
DOI:
10.1136/bmjopen-2016-013658
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center