Medication prescription profile and hospital admission related to medication administration errors in England and Wales: an ecological study

BMJ Open. 2023 Nov 19;13(11):e079932. doi: 10.1136/bmjopen-2023-079932.

Abstract

Objective: To explore the correlation between prescribing rate of medications and hospital admissions related to medications administration errors in England and Wales during the time from 1999 to 2020.

Design: An ecological study.

Setting: A population-based study using hospital admission data that are publicly available in the UK. Data in this study were extracted from the Hospital Episode Statistics database in England and the Patient Episode Database in Wales from Wales. The Prescription Cost Analysis database was used to extract the prescription data.

Participants: Patients who were hospitalised all National Health Service (NHS) trusts and any independent sector funded by NHS trusts.

Primary outcome measure: Hospitalisation rates related to medication administration errors and its associated prescriptions.

Results: The annual rate of hospital admissions related to medication administration errors increased by 32.0% (from 184.21 (95% CI 183.0 to 185.4) in 1999 to 243.18 (95% CI 241.9 to 244.4) in 2020 per 100 000 persons. The most common three indications of hospital admissions were T39 (non-opioid analgesics, antipyretics and antirheumatics), T43 (psychotropic drugs), T42 (antiepileptic, sedative-hypnotic and antiparkinsonism drugs). The age group 15-59 years had the highest number of hospital admissions (83.4%). Women contributed to 59.1% of the total number of hospital admissions. Admission rate among men increased by 16.7%. Among women, the admission rate increased by 44.6%.

Conclusion: Admission rates due to medication administration errors increased markedly in the past decade. This increase was correlated with an increase in the prescription rate of several therapeutic classes. Patients taking non-opioid analgesics, antipyretics and antirheumatics, psychiatric medications, antiepileptic, sedative-hypnotic and antiparkinsonism drugs should have their recommended (and administered) doses closely monitored. They should be followed up on a regular basis to ensure that they are taking their medications as prescribed.

Keywords: ACCIDENT & EMERGENCY MEDICINE; EPIDEMIOLOGY; Health & safety; Hospitalization; PUBLIC HEALTH.

MeSH terms

  • Adolescent
  • Adult
  • Analgesics, Non-Narcotic*
  • Anticonvulsants
  • Antipyretics*
  • Drug Prescriptions
  • England
  • Female
  • Hospitalization
  • Hospitals
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Male
  • Middle Aged
  • State Medicine
  • Wales
  • Young Adult

Substances

  • Analgesics, Non-Narcotic
  • Antipyretics
  • Anticonvulsants
  • Hypnotics and Sedatives