1127 Medication Errors In General Practice - Types Of Errors In Oral Anticoagulation And Antihypertensive Treatment

Eckart Blauth, Johann Wolfgang Goethe University Hospital
E. Blauth - Research Associate
K. Saal - Research Associate
J. Rohe - Research Associate
M. Beyer - Senior Researcher
F. M. - Director Institute for General Practice
Oral Communication
Medication errors represent 11-35% of errors in general practice. These results are mainly derived from retrospective analysis of routine data. Therefore, causes and mechanisms of errors in general practice are hardly known. Our aim was to search patient documentation systematically for potential errors in oral anticoagulation and antihypertensive therapy by the use of guideline-based indicators and pharmacological databases on interactions, and to investigate the underlying causes in cooperation with the prescribing physician.
Design & Methods:
All relevant data concerning prescriptions in the observation period (1 year) was collected from patient charts. We performed semi-structured patient interviews. Following international guidelines for oral anticoagulation and antihypertensive therapy, we developed criteria lists to identify conspicuous incidents. Several databases (Micromedex ® etc.) were used to screen medication for contraindications and interactions. All conspicuous incidents were discussed with the prescribing physician.
Eighteen GPs participated with 252 patients. We found 230 relevant incidents in 102 patients using oral anticoagulation and 232 incidents in 150 patients with hypertension. These incidents mostly concern monitoring, interactions and the quality of treatment documentation itself.
It is possible to identify medication errors by systematically analysing patient documentation. We will discuss a classification based on causes and the correlation of patient attributes or practice routines and the types of identified errors.
On the basis of these findings tools to prevent especially slips and lapses, e.g. check-lists or optimised practice routines, should be developed.
Medication errors in general practice - types of errors in oral anticoagulation and antihypertensive treatment