Adverse events recorded in English primary care: observational study using the General Practice Research Database

Area of Science:

• General Practice Research
• Patient Safety
• Health Services Research

Background:

• Accurate estimates of adverse events in primary care are crucial for resource allocation to improve patient safety.
• Identifying predictors of iatrogenic harm is essential for mitigating patient risk.

Purpose of the Study:

• To determine the incidence of recorded iatrogenic harm in English general practice.
• To identify risk factors associated with these adverse events.

Main Methods:

• A cross-sectional study analyzed data from 74,763 patients across 457 English general practices (1999-2008).
• Data included patient demographics, practice characteristics, comorbidities, and health service use.
• Adverse events were identified using Read Codes; analyses employed Poisson regression with generalized estimating equations.

Main Results:

• The incidence of recorded adverse events was 6.0 per 1000 person-years.
• Risk factors for adverse events included older age (65-84 years), high consultation frequency, multiple emergency admissions, and a greater number of comorbidities.
• Longer duration of patient registration at a practice was associated with a lower risk of adverse events.

Conclusions:

• The incidence of recorded adverse events in primary care is relatively low and comparable to other studies.
• Further research using data triangulation and exploring the predictive value of first adverse events for future incidents is recommended.