Primary care physicians' perceptions of medication errors and error prevention in cooperation with community pharmacists

Background: Physicians and community pharmacists play a major role in safe use of medication in primary outpatient care. Still, little is known about primary care physicians' perceptions of medication errors and error prevention and how they would like to cooperate with community pharmacists in error prevention and management.

Objectives: To explore primary outpatient care physicians' perceptions of medication errors and error prevention and to examine physicians' perceptions and expectations of cooperation with community pharmacists in error prevention and management.

Methods: A national mail survey containing structured and open-ended questions to a random sample of 15% of Finnish public health care physicians and occupational health physicians (n=639) was carried out.

Results: A total of 179 responses were entered into the study (29% response rate). The potential causes of medication errors were most often related to physicians (39%), followed by the causes related to the organization (23%) and patient (19%). The factors concerning physicians' unawareness of patients' comedication arose as the major causes of medication errors. The respondents considered workload as a primary cause for medication errors. The most frequently mentioned actions to prevent medication errors were related to the physician (31%), organization (28%), and information technology (22%). The respondents expected more contacts from community pharmacists than actually occurred, particularly in the cases of potential drug abuse and problems in drug use.

Conclusions: Problems related to polypharmacy because of physicians' unawareness of patients' entire current medication were considered as most challenging in medication safety. Many of the problems were contributed to communication and coordination issues, which could be ameliorated by appropriate use of information technology. The study also indicated a need to develop the cooperation between primary care physicians and community pharmacists to enhance medication safety.