Medication incidents in primary care medicine: protocol of a study by the Swiss Federal Sentinel Reporting System

Abstract

Background/rationalePatient safety is a major concern in healthcare systems worldwide. Although most safety research has been conducted in the inpatient setting, evidence indicates that medical errors and adverse events are a threat to patients in the primary care setting as well. Since information about the frequency and outcomes of safety incidents in primary care is required, the goals of this study are to describe the type, frequency, seasonal and regional distribution of medication incidents in primary care in Switzerland and to elucidate possible risk factors for medication incidents.Methods and analysisStudy design and setting: We will conduct a prospective surveillance study to identify cases of medication incidents among primary care patients in Switzerland over the course of the year 2015. Participants: Patients undergoing drug treatment by 167 general practitioners or paediatricians reporting to the Swiss Federal Sentinel Reporting System. Inclusion criteria: Any erroneous event, as defined by the physician, related to the medication process and interfering with normal treatment course. Exclusion criteria: Lack of treatment effect, adverse drug reactions or drug–drug or drug–disease interactions without detectable treatment error. Primary outcome: Medication incidents. Risk factors: Age, gender, polymedication, morbidity, care dependency, hospitalisation. Statistical Analysis: Descriptive statistics to assess type, frequency, seasonal and regional distribution of medication incidents and logistic regression to assess their association with potential risk factors. Estimated sample size: 500 medication incidents. Limitations: We will take into account under-reporting and selective reporting among others as potential sources of bias or imprecision when interpreting the results.Ethics and disseminationNo formal request was necessary because of fully anonymised data. The results will be published in a peer-reviewed journal.Trial registration numberNCT0229537.

The nature, severity and causes of medication incidents from an Australian community pharmacy incident reporting system: The QUMwatch study

“…15 Data on medication safety, nevertheless, remain scarce in primary care, such as community pharmacy, relative to the hospital setting. 55 In our study, the classes of medicines involved in MIs generally corresponded with their frequency of use in the community 56 and with other primary care studies. 24,47,51,57 Cardiovascular and analgesic medicines alone appear to account for the majority of MIs that occur in the community.…”

Medication incidents in primary care medicine: a prospective study in the Swiss Sentinel Surveillance Network (Sentinella)

“…The Sentinella physicians are representative for the overall Swiss physician population. 5 Drugs were autodistributed by 42% of the study practices. Approximately half of the physicians had electronic and the other paper-based medical records.…”

“…The latter covers a representative sample of patients in primary care for Switzerland. 5 Founded in 1986, it was mainly designed to survey transmissible diseases. Later, it also assessed other health problems of public interest.…”

“… 2–4 Information about the frequency and outcomes of safety incidents in primary care is required to identify risks or ‘hot spots’, to prioritise them and to take action as needed. 5 The aim of the project was to describe the type, incidence, seasonal and regional distribution of medication incidents in primary care in Switzerland and to elucidate risk factors for medication incidents.…”

Chronic conditions and multimorbidity in a primary care population: a study in the Swiss Sentinel Surveillance Network (Sentinella)

“…This analysis was based on the data generated by the Swiss Sentinel Surveillance Network ( Sentinella ) (Gnädinger et al 2015 ). Sentinella is a network of approximately 180 general practitioners (GPs) and pediatricians (PEDs) and was founded in 1986 in order to survey communicable diseases in Switzerland (Federal Office of Public Health 2018 ).…”