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Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

Repeat prescribing safety survey

Steven Lillis 1 5 , Nicki Macklin 1 , Michael Thorn 1 , Emma Wicks 1 , Kristin Good 2 , Liza Lack 1 , Richard Medlicott 1 , Catherine Proffitt 3 , Helen Rodenburg 1 , Vanessa Souter 1 , Pam Duncan 4 , Lucia Bercinskas 1 , Stephanie Fletcher 1 , Alison Molloy 1
+ Author Affiliations
- Author Affiliations

1 Royal New Zealand College of General Practitioners, PO Box 10440, Wellington, New Zealand.

2 Accident Compensation Corporation, PO Box 242, Wellington, New Zealand.

3 PHARMAC, PO Box 10254, Wellington, New Zealand.

4 Pharmacy Council of New Zealand, PO Box 25137, Wellington, New Zealand.

5 Corresponding author. Email: steven.lillis@outlook.co.nz

Journal of Primary Health Care 11(3) 243-248 https://doi.org/10.1071/HC19019
Published: 30 September 2019

Journal Compilation © Royal New Zealand College of General Practitioners 2019 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

Abstract

INTRODUCTION: Repeat prescribing is an accepted part of general practice activities in New Zealand and in many developed countries. However, there has been little research on how this service is used in New Zealand, or on clinicians’ attitudes towards it.

AIM: To discover the opinions of vocationally registered general practitioners (GPs) and general practice registrars regarding repeat prescribing, availability of practice policy and mechanisms for issuing such prescriptions.

METHODS: A survey was developed by an expert group and shared through the Royal New Zealand College of General Practitioners’ (the College) weekly newsletter, epulse, inviting members to participate in the survey. The survey was also emailed to registrars.

RESULTS: In total, 144 vocationally registered GPs and 115 registrars responded (n = 259), giving a response rate of 3.2% for GPs and 12.7% for registrars. Patient convenience and time efficiency for the practice were the most commonly cited reasons for repeat prescribing. Registrars had low awareness of practice policy on repeat prescribing and only one-quarter of practices had an orientation pack that contained advice on repeat prescribing.

DISCUSSION: Better practice systems are likely to improve the safety profile of repeat prescribing and should be addressed. There is substantial unwanted variability currently in these practice systems.


References

[1]  Avery T, Barber N, Ghaleb M, et al. Investigating the prevalence and causes of prescribing errors in general practice: The Practice Study. London: General Medical Council; 2012.

[2]  Panesar SS, deSilva D, Carson-Stevens A, et al. How safe is primary care? A systematic review. BMJ Qual Saf. 2016; 25 544–53.
How safe is primary care? A systematic review.Crossref | GoogleScholarGoogle Scholar | 26715764PubMed |

[3]  Swinglehurst D, Greenhalgh T, Russell J, Myall M. Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study. BMJ. 2011; 343 d6788
Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study.Crossref | GoogleScholarGoogle Scholar | 22053317PubMed |

[4]  Price J, Man SL, Bartlett S, et al. Repeat prescribing of medications: a system-centred risk management model for primary care organisations. J Eval Clin Pract. 2017; 23 779–96.
Repeat prescribing of medications: a system-centred risk management model for primary care organisations.Crossref | GoogleScholarGoogle Scholar | 28370904PubMed |

[5]  Garth B, Temple-Smith M, Clark M, et al. ‘Your lack of organisation doesn’t constitute our emergency’ – repeat prescription management in general practice. Aust Fam Physician. 2014; 43 404–8.
| 24897993PubMed |

[6]  Avery T. Avoidable prescribing errors: incidence and the causes. Prescriber. 2010; 21 52–5.
Avoidable prescribing errors: incidence and the causes.Crossref | GoogleScholarGoogle Scholar |

[7]  Magrabi F, Liaw ST, Arachi D, et al. Identifying patient safety problems associated with information technology in general practice: an analysis of incident reports. BMJ Qual Saf. 2016; 25 870–80.
Identifying patient safety problems associated with information technology in general practice: an analysis of incident reports.Crossref | GoogleScholarGoogle Scholar | 26543068PubMed |

[8]  Price J, Baylis D, Taylor K, et al. Impact of a systems – centred intervention for reducing repeat prescribing risks in a large Primary Care Organisation. Qual Prim Care. 2017; 26 64–73.

[9]  Avery AJ, Rodgers S, Cantrill JA, et al. A pharmacist-led information technology intervention for medication errors (PINCER): a multicentre, cluster randomised, controlled trial and cost-effectiveness analysis. Lancet. 2012; 379 1310–9.
A pharmacist-led information technology intervention for medication errors (PINCER): a multicentre, cluster randomised, controlled trial and cost-effectiveness analysis.Crossref | GoogleScholarGoogle Scholar | 22357106PubMed |

[10]  RNZCGP. General Practice Workforce Survey – Part 1. Wellington: Royal New Zealand College of General Practitioners; 2017.

[11]  Lillis S, Lord H. Repeat prescribing – reducing errors. J Prim Health Care. 2011; 3 153–8.
| 21625665PubMed |

[12]  Avery AJ. Repeat prescribing in general practice. BMJ. 2011; 343 d7089
Repeat prescribing in general practice.Crossref | GoogleScholarGoogle Scholar | 22053318PubMed |

[13]  Health and Disability Commissioner. Prolonged NSAID prescribing without appropriate monitoring. Wellington: HDC; 2017. [cited 2019 August 26]. Available from: https://www.hdc.org.nz/decisions/search-decisions/2017/16hdc00594/

[14]  Bowie P, McKay J, Kelly M. Maximising harm reduction in early specialty training for general practice: validation of a safety checklist. BMC Fam Pract. 2012; 13 62
Maximising harm reduction in early specialty training for general practice: validation of a safety checklist.Crossref | GoogleScholarGoogle Scholar | 22721273PubMed |