Practice staff guard against prescribing errors, study finds

Practice staff are an important safeguard against repeat prescribing errors, research suggests.

Receptionists and administrative staff play an important but often ‘hidden’ part in managing repeat prescriptions, according to a study published in the BMJ.

Earlier work had suggested that over-reliance on electronic health records may affect the quality and safety of repeat prescribing.

In the study, researchers found the flexibility of staff to make practice judgements can span the gap between formal protocols and reality. This improves the safety and quality of repeat prescribing, they concluded.

Repeat prescriptions account for up to three quarters of all medicines prescribed and four fifths of drug costs in general practice. But repeat prescribing has prompted concerns over safety and quality.

Researchers from Queen Mary, University of London, examined how GPs, receptionists and other administrative staff contributed to repeat prescribing behaviour at four UK general practices.

Their investigations found repeat prescribing to be a complex practice supported by technology and requiring collaboration between clinicians and practice staff.

They said there was a ‘model/reality gap’ exists between formal prescribing protocols and the real time activity of repeat prescribing. Clinicians were often unaware of the practical judgements made by staff in this area, they found.

In an accompanying editorial, Professor Anthony Avery of the University of Nottingham Medical School said: ‘It seems reasonable to encourage well trained receptionists to use their initiative in repeat prescribing, but practices need to ensure that members of staff do not step beyond their levels of knowledge and competence.’

Although there is` little evidence of concern about receptionists’ autonomy on repeat prescribing, errors do occur and further research should be conducted to elucidate why, he concluded.

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