The difference in the incidence of 126 high-risk prescribing errors pre- and post-EPMA implementation using iMPACT tool

Abstract

Background: A prescribing error (PE) is defined as any unintentional significant reduction in the probability of treatment being timely and effective or an increase in the risk of harm due to a prescribing decision. The number of medication errors in the UK in 2019 was estimated at 237 million. PEs accounted for 21%. The Investigating Medication Prescribing Accuracy for Critical Error Types (iMPACT) tool provides a standardised way of collecting and defining PEs. iMPACT uses 126 pre-defined high-risk prescribing error indicators (PEIs). They were chosen by the iMPACT team. PEIs were based on the severity of different PEs in various clinical scenarios. This study contributes to adding evidence to the existing literature about PE rates in the UK. Methods: A prospective pre and post-quasi-study at Bart’s Health NHS Trust using the iMPACT tool over a 2–3-week period pre-and post-EPMA. Error rate, error type, the most common medicines associated with errors, and the clinical decision were identified and analyzed. Results: There was a significant difference in the total prescribing error rates between pre- and post-EPMA with a p-vlaue<0.001. Prescribing error rates were significantly reduced in five of the indicators pre-and post-implementation comparison. The most common type of error post-EPMA was seen in drug interaction. Conclusion: This study's findings could help optimize the patients’ care in the future. Most of the indicators had a lower error rate post-EPMA; however, some of them had a higher rate even if it was not significant.