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Patient-reported safety incidents in older patients with long-term conditions: a large cross-sectional study
  1. Maria Panagioti1,
  2. Thomas Blakeman1,2,
  3. Mark Hann1,
  4. Peter Bower1,3
  1. 1 NIHR School for Primary Care Research Centre for Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
  2. 2 National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Greater Manchester, Centre for Primary Care, University of Manchester, Manchester, UK
  3. 3 NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre (Greater Manchester PSTRC), Manchester Academic Health Science Centre University of Manchester, Manchester, UK
  1. Correspondence to Dr Maria Panagioti; maria.panagioti{at}


Background Increasing evidence suggests that patient safety is a serious concern for older patients with long-term conditions. Despite this, there is a lack of research on safety incidents encountered by this patient group. In this study, we sought to examine patient reports of safety incidents and factors associated with reports of safety incidents in older patients with long-term conditions.

Methods The baseline cross-sectional data from a longitudinal cohort study were analysed. Older patients (n=3378 aged 65 years and over) with a long-term condition registered in general practices were included in the study. The main outcome was patient-reported safety incidents including availability and appropriateness of medical tests and prescription of wrong types or doses of medication. Binary univariate and multivariate logistic regression analyses were undertaken to examine factors associated with patient-reported safety incidents.

Results Safety incidents were reported by 11% of the patients. Four factors were significantly associated with patient-reported safety incidents in multivariate analyses. The experience of multiple long-term conditions (OR=1.09, 95% CI 1.05 to 1.13), a probable diagnosis of depression (OR=1.36, 95% CI 1.06 to 1.74) and greater relational continuity of care (OR=1.28, 95% CI 1.08 to 1.52) were associated with increased odds for patient-reported safety incidents. Perceived greater support and involvement in self-management was associated with lower odds for patient-reported safety incidents (OR=0.95, 95% CI 0.93 to 0.97).

Conclusions We found that older patients with multimorbidity and depression are more likely to report experiences of patient safety incidents. Improving perceived support and involvement of patients in their care may help prevent patient-reported safety incidents.

  • patient safety
  • multimorbidity
  • patient-reported
  • depression

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  • Funding MP and PB authored and are guarantors of this manuscript. MP led all aspects of data collection and analysis, and drafted and finalised the manuscript. TB and MH assisted with data analysis and critically reviewed the manuscript. PB conceived the research design, critically revised the manuscript and assisted with data analysis and interpretation. All authors approved the final manuscript. NIHRSchool for Primary Care Research funded some of the time and facilities of MP.

  • Funding This publication/paper is independent research part funded by the NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre and the National Institute of Health Research Health Services and Delivery Programme (project 12/130/33). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Ethics approval This study was approved by the NRES Committee North West Lancaster (Ref: 14/NW/0206), and all participants provided informed consent prior to participation.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.