Table 3

Causes of PCIs (using The PCNE Classification V 5.01)
Primary domain Code V5.01 Cause Frequency (%, n = 706)
1. Drug/Dose selection C1.1 Inappropriate drug selection 7 (1.0)
C1.2 Inappropriate dosage selection 10 (1.4)
C1.3 More cost-effective drug available 2 (0.3)
C1.4 Pharmacokinetic problems, include ageing/deterioration in organ function and interactions 5 (0.7)
C1.5 Synergistic/preventive drug required and not given 11 (1.6)
C1.6 Deterioration/improvement of disease state 150 (21.2)
C1.7 New symptom or indication revealed/presented 75 (10.6)
C1.8 Manifest side effect, no other cause 93 (13.2)
Subtotal 1 353 (50.0)
2. Drug use process C2.1 Inappropriate timing of administration and/or dosing intervals 44 (6.2)
C2.2 Drug underused/ under-administered 5 (0.7)
C2.3 Drug overused/ over-administered 9 (1.3)
C2.6 Patient unable to use drug/form as directed 2 (0.3)
C2.7 Too many medications* 6 (0.8)
C2.8 Inappropriate duration of use* 1 (0.1)
C2.9 New drug prescribed* 2 (0.3)
Subtotal 2 69 (9.8)
3. Information C3.1 Instructions for use/taking not known 2 (0.3)
C3.2 Patient unaware of reason for drug treatment 16 (2.3)
C3.5 Lack of communication between HCPs 1 (0.1)
C3.6 Miscommunication between doctor and patient* 4 (0.6)
C3.7 Unclear label* 6 (0.8)
Subtotal 3 29 (4.1)
4. Patient/Psychological C4.1 Patient forgets to use/take drug 34 (4.8)
C4.2 Patient has concerns with drugs 24 (3.4)
C4.3 Patient suspects side effects 37 (5.2)
C4.4 Patient unwilling to carry financial cost 6 (0.8)
C4.7 Patient unwilling to adapt life-style 3 (0.4)
C4.8 Burden of therapy 3 (0.4)
C4.9 Treatment not in line with health beliefs 6 (0.8)
C4.11 Religious belief* 6 (0.8)
C4.12 Patient unaware of possible complications* 8 (1.1)
C4.13 Patient unaware of drug name* 5 (0.7)
C4.14 Out of medication* 7 (1.0)
C4.15 Overseas or travelling* 9 (1.3)
C4.16 Patient smoking* 7 (1.0)
C4.17 Patient unaware of tablet strength* 1 (0.1)
C4.18 Patient does not trust HCPs* 1 (0.1)
C4.19 Patient on traditional medicine* 1 (0.1)
C4.20 Patient on too many supplements* 3 (0.4)
C4.21 Patient’s meal time is different* 1 (0.1)
C4.22 Patient shared medications 1 (0.1)
C4.23 Non-adherence to medications* 65 (9.2)
Subtotal 4 228 (32.3)
5. Logistics C5.2 Prescribing error (only in case of slip of the pen) 1 (0.1)
C5.3 Dispensing error (wrong drug or dose dispensed) 1 (0.1)
Subtotal 5 2 (0.3)
6. Others C6.11 Patient anxious about glucose level* 1 (0.1)
C6.12 Patient not sure of using glucose meter or other devices* 2 (0.3)
C6.13 Wrong frequency of glucose monitoring* 1(0.1)
C6.14 Drug stored in unsuitable condition* 2 (0.3)
C6.15 Patient not on medication in record* 3 (0.4)
C6.2 No obvious cause 16 (2.3)
Subtotal 6 25 (3.5)

*Subclasses added, not in The PCNE Classification V 5.01.

HCPs = Healthcare professionals.

Chua et al.

Chua et al. BMC Health Services Research 2012 12:388   doi:10.1186/1472-6963-12-388

Open Data