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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