Errors, Optimisation and Deprescribing
Distinguish dangerous errors from ineffective, duplicative or suboptimal prescribing and identify the safest correction.
How to prepare for the PSA
Combine patient-centred prescribing judgement with fast BNF navigation, reliable calculations, complete prescriptions and explicit monitoring and communication.
Core concepts
Concept 1
A review may reveal an administrable dosing error, wrong route, therapeutic duplication, ineffective treatment or unsafe timing.
Exam cue: Ask whether the prescription could reach the patient as written and what harm or treatment failure could follow.
Concept 2
Optimisation includes stopping unnecessary medicine, correcting a prescription, simplifying treatment and aligning timing with benefit and harm.
Exam cue: Separate a serious error from a suboptimal but less urgent choice.
Concept 3
Elderly-care scenarios particularly emphasise frailty, polypharmacy and proportionate deprescribing without abrupt or unsupported changes.
Exam cue: For deprescribing, consider indication, current benefit, withdrawal risk and monitoring.
Risk pitfalls and guardrails
Calling every imperfection a serious dosing error.
Guardrail: Do not let a familiar medicine, reference search or calculator output replace patient-specific safety checks and escalation.
Stopping several medicines simply because the list is long.
Guardrail: Do not let a familiar medicine, reference search or calculator output replace patient-specific safety checks and escalation.
Ignoring administration timing, formulation or route because the drug choice itself is reasonable.
Guardrail: Do not let a familiar medicine, reference search or calculator output replace patient-specific safety checks and escalation.
Memory anchors
Administrable Error
Prioritise an error that could feasibly reach the patient as prescribed.
Therapeutic Duplication
Check whether two entries unnecessarily deliver the same or overlapping treatment.
Suboptimal Timing
A correct medicine may still be poorly timed for safety, adherence or intended effect.
Deprescribing
Review indication, benefit, harm, withdrawal and follow-up before stopping treatment.
Polypharmacy
A long list prompts structured review, not automatic discontinuation.
Checkpoint rule
Do the check-up only after you can summarize each concept in one sentence and identify one dangerous pitfall from memory.
Knowledge Check (after reading)
Short check-up to confirm understanding of this module.
Check-up Questions
A chart says insulin “10 U.” What is the safest correction?
A prescription reads morphine oral solution 10 mg but omits concentration and volume. What should happen?
Answer all questions to submit.
Next step personalized recommendations
Continue learning
Move forward only after this module is stable.
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