This article was originally published in July 2024. Since then, the study has been peer reviewed and published in [BMJ Quality & Safety](https://doi.org/10.1136/bmjqs-2024-017733). The preprint suggested a 76.5% reduction in prescribing errors, which was revised to 84%.

• Study from a team of Imperial College researchers, including Lord Ara Darzi

• 84% reduction in prescribing errors

• 20% reduction in time to prescribe

• 96% felt Dosium reduced their workload around prescribing

A new study from a team of Imperial College researchers has shown that the use of Dosium reduces prescribing errors by 84% compared with standard clinical practice. [1]

The real-world simulation study was conducted at a large London NHS trust and published as a preprint in summer 2024, awaiting peer review. [2] It observed prescribers making 240 simulated medication orders designed to reflect real-world scenarios, and noted how existing workflows were prone to error, for example due to high complexity, unreliability of current systems, and the need to cross-reference the British National Formulary (BNF) with local guidelines.

The use of Dosium, which has an exclusive integration with the BNF and automates precise dosing recommendations based on individual patient factors, was associated with 76.5% fewer prescribing errors compared to standard practice in the preprint. Additionally, using the solution reduced the time it took to prescribe by 20%. 96% of users felt the tool reduced their workload around prescribing.

Medication errors are a serious and pervasive issue, totalling 237M in England every year, with approximately 1.8M serious prescribing errors. [3]

“No software system can tell me, as a prescribing clinician, the correct dose for my patient, from the national formulary, across the breadth of conditions I might encounter in a day.

This study proves that drawing this crucial information live, directly from the BNF, on an ongoing basis, significantly improves safety.”

NA

Dr Nicholas Appelbaum

Co-Founder, Dosium

“Despite the NHS investing hundreds of millions of pounds in electronic prescribing and clinical decision support systems, the data is unforgiving. These technologies have not significantly impacted patient safety,” Nicholas added. “The focus to date has often been on more peripheral issues in electronic prescribing, such as drug interaction checking, which only accounts for a small percentage of medication errors.”

Users appreciated the system’s potential to reduce prescribing errors in real-world practice, streamline workflows, and remove the need for complex calculations (such as for body surface area or ideal body weight). They also praised the user-friendly interface and layout, noting clarity, ease of navigation, and better presentation of BNF data compared to current methods.

Read the full study, or contact us to discuss bringing Dosium to your clinical practice.

About the researchers

Professor Lord Ara Darzi

Professor Darzi holds the Paul Hamlyn Chair of Surgery at Imperial College London, the Royal Marsden Hospital and the Institute of Cancer Research. He is Director of the Institute of Global Health Innovation at Imperial College London and Chair of Imperial College Health Partners. He is an Honorary Consultant Surgeon at Imperial College Healthcare NHS Trust.

Professor Darzi is an Honorary Fellow of the Royal Academy of Engineering, a Fellow of the Academy of Medical Sciences, and a Fellow of the Royal Society. He was knighted for his services in medicine and surgery in 2002.

Professor Darzi was the United Kingdom’s Global Ambassador for Health and Life Sciences until March 2013, during which time he developed his status as a leading voice in global health policy and innovation. He has been a member of the Privy Council since June 2009.

Professor Bryony Dean Franklin

Professor Franklin is Director of the Centre for Medication Safety and Service Quality (CMSSQ), a joint research unit between Imperial College Healthcare NHS Trust, where she is also Executive Lead Pharmacist for Research, and UCL School of Pharmacy, where she is Professor of Medication Safety.

She is Director of the NIHR North West London Patient Safety Research Collaboration, and a theme lead within the NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London. She is visiting Professor at Imperial College, and Co-Editor-in-Chief of BMJ Quality & Safety.

Dr Jonathan Clarke

A general surgeon by training, Jonathan is a Member of the Royal College of Surgeons and holds a Masters in Public Health from Harvard University, where he was a Kennedy Scholar. More recently he returned to Harvard University as a Visiting Fellow in Biostatistics with the Onnela Lab.

Jonathan has worked internationally with the United Nations, World Health Organization, Médecins du Monde and the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University to document the human rights infringements across Europe that result from discriminatory health policies towards migrants. He serves as an advisor to the Institute for the Future of Work and is a Scientific Advisor to the Helix Centre for Design in Healthcare, where he examines how the generation, synthesis and use of clinical guidance affects patient care.

Calandra Feather

Calandra is completing her PhD, using user-centred, mixed-method studies to evaluate prescribing practice, indication documentation, and the use of Dosium’s Touchdose compared with current practice. As Clinical Safety Officer for Dosium, she works to identify and document potential hazards and ensure controls are in place to minimise the risk of errors and harm.

She also holds an honorary health services researcher role in the Centre for Medication Safety and Service Quality at Imperial College Healthcare NHS Trust and is an honorary Clinical Research Fellow at Imperial College London. She has been a guest lecturer on the Imperial College Masters programmes in Patient Safety and Healthcare Design. Calandra is a registered paediatric nurse and specialised in intensive care before moving into clinical academic research.

Dr Nicholas Appelbaum

Nicholas trained as a doctor in Cape Town, South Africa, working as a general surgeon before relocating to the UK to complete a PhD at Imperial College London. He made this move in direct response to witnessing the high risk and prevalence of drug errors in his daily clinical practice, and to the “terror” he felt when prescribing drugs, particularly for children. Nicholas worked on his research project directly alongside Lord Ara Darzi, focusing on innovative strategies to enhance patient safety and reduce unnecessary variation in guideline-influenced care.

He went on to co-found Dosium in 2017 at the Helix Centre, the research lab of Imperial College London and the Royal College of Art, where he led an NIHR-funded project to build a frontline decision support tool for paediatric emergency medicine. At that time, he also began Dosium’s long-standing collaboration with the Royal Pharmaceutical Society to put the BNF at the heart of UK-centric medication safety software.

Nicholas has also worked as Clinical Lead for the Helix Centre, where he oversaw the clinical research portfolio. He is an Honorary Research Fellow at Imperial College London’s Institute of Global Health Innovation.