Computer prescribing systems in UK general practices are endangering patients’ lives

Computer prescribing systems in UK general practices are endangering patients’ lives by failing to pick up on some hazardous drug combinations, say researchers in this week’s British Medical Journal.

Researchers from the Universities of Edinburgh and Nottingham and General Practitioners in Kent tested four computer systems currently in use in about three quarters of the UK general practices. All of them failed to detect known prescribing errors, especially where drugs were contraindicated.

Serious failures discovered by researchers included allowing the prescription of the oral contraceptive pill to women with a history of deep vein thrombosis. On test, the system also permitted the prescription of aspirin to a child. There is a known risk of aspirin causing children to develop Reye’s syndrome, a potentially fatal disorder.

The NHS Information Authority regulates the use of general practice computer systems, but gives only general references to safety and there is evidence that they do not prevent contraindicated prescribing. Hospital systems already exist that link patient history, laboratory results and prescribing data. This informs, and sometimes forbids, the prescriber to continue.

Professor Aziz Sheikh, Professor of Primary Care Research and Development at the University of Edinburgh said: “Prescribing errors are common, costly to the NHS and can result in significant ill health and death, but most prescribing errors are preventable. It is recognised that general practice IT systems offer the potential to cut the number of these errors, as computers can reduce medication error rates by as much as 60%. Most of the problems we discovered in this study can be resolved, though, and one solution is to have tighter regulations about suppliers flagging up prescribing alerts. We also need to have regular dialogue between the system and drug database users.”

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