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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.
- patient safety
- pharmaceutical preparations
- medication errors.
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Footnotes
Contributors MG led the study, did the pilot study (questionnaire development, data entering and processing), wrote all documents, did all the contacts with the Sentinella administration, ethics committee and others, programmed the electronic questionnaires, entered hand-written questionnaires into the database, did the data processing and wrote the publication after data collection. AC is an expert on clinical pharmacology and drug safety. DC is an expert on patient safety. LH is French-speaking and helped to interpret the French questionnaires. She is an expert on multimorbidity. She is a member of the Sentinella programme commission. MP is head of Epidemiology, Biostatistics & Prevention Institute. He is responsible for the sound methodology. AS had the idea for the study. He is vice president of the Sentinella programme commission. MZ is expert on electronic data exchange in primary care. All of them have seen all the study documents and have contributed intellectually to their elaboration. All have contributed to revise the draft of this publication and approve the submitted version of this publication.
Funding The study was funded by Bangerter-Rhyner Foundation, Basel.
Competing interests None declared.
Ethics approval Ethics commission of Canton Zurich Switzerland.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available. Anonymized raw data can be demanded from the corresponding author.