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GP contract work swamping safety drive on drug names

GPs are ignoring a key Government patient safety drive to standardise drug names – and risking potential legal action – because they are swamped with work implementing the new contract.

The Chief Medical Officer has set a deadline of June 30 for GPs to perform risk assessments in their practices covering the switch in drug names, to minimise prescribing errors and patient confusion. But GP prescribing experts say few practices have taken action so far.

Currently, two different names may be used for certain drugs: BANs (British Approved Names) and rINNs (recommended International Nonproprietary Names).

Some of the changes are minor, such as replacing amox- ycillin (BAN) with amoxicillin (rINN). But others are potentially more serious (see box).

Last week, the Medicines and Healthcare products Regulatory Agency (MHRA) stressed the importance of the move as it reported three serious medication errors involving confusion between a BAN drug (cysteamine) and a rINN (mercaptamine).

The agency said GPs should follow guidance from the National Patient Safety Agency, which states practices should update prescribing databases, change repeat prescribing forms, alert patients and their carers and conduct risk assessments.

An MHRA spokeswoman said the issue was of particular concern in practices that used handwritten prescriptions and in out-of-hours services where drugs are stockpiled.

But Dr Chaand Nagpaul, a member of the GPC prescribing sub-committee and a GP in Harrow, Middlesex, said GPs were ignoring the changes.

'This has to be addressed because it will affect GP prescribing, nurse prescribing and will require a concerted local effort,' he added. 'But the truth is, everyone's attention and energy is focused on the new contract and at a local

level nothing is being done. PCTs will probably alert GPs to the deadline a week before.'

Dr Nick Norwell, medico-legal adviser at the Medical Defence Union, said GPs were at particular risk because the majority used generic names.

'GPs should be aware of this risk and be extra vigilant against medication errors because the legal responsibility for prescribing lies with the doctor who signs the prescription. GPs are advised to check with software manufacturers about updates for computerised prescribing systems and drop-down formularies.'

Major drug name changes

Old drug name (BAN) New drug name (rINN)

Bendrofluazide Bendroflumethiazide

Benzhexol Trihexyphenidyl

Nicoumalone Acenocoumarol

Source: Medicines and Healthcare Products Regulatory Agency

For full list see www.mhra.gov.uk

By Brian Kelly

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