Thousands of GP practices to avoid hazardous prescribing

University of Nottingham team and FDB (First Databank) partner to flag crucial national safety indicators to thousands of primary care professionals through prescribing software

More than 4,000 GP practices in England are being better empowered to avoid hazardous prescribing, following a key enhancement to a prescribing decision support technology used widely across the country.

Crucial ‘PINCER’ (Pharmacist-led Information technology iNtervention for the reduction of Clinically important ERrors in medicines management) prescribing safety indicators, currently being rolled out nationally to avoid errors and hazardous prescribing, will now be flagged directly to thousands of GPs and other primary care prescribers when relevant prescribing decisions are made in the practice for patients.

In practice, FDB’s OptimiseRx technology, a medicines management system currently used across two thirds of clinical commissioning groups, will now alert GPs and other primary care prescribers, either at point of prescription or reauthorising of medications, when PINCER safety indicators are relevant for specific patients.

The development complements a national drive for the use of the indicators by specially-trained pharmacists in primary care, which is a key part of the NHS England’s strategy for reducing harm from medications in the NHS.  In addition, practices in England will be uploading their PINCER results to a national database for analysis purposes.

Research suggests that serious errors are believed to affect one in 550 prescription items, while hazardous prescribing in general practice has been said to contribute to around 1 in 25 hospital admissions.

For the national roll-out, a combination of earlier sets of PINCER indicators in the original research trial, and subsequent programmes of work, are being used which are focused on both prescribing and monitoring aspects of medication safety.

The PINCER intervention helps identify patients at risk of hazardous prescribing. Using the principles of root cause analysis, a pharmacist then works with the practice to draw up action plans to address any immediate risk, and changes to systems and processes required to prevent any error from recurring.

To further mitigate the potential for hazardous prescribing, the indicators are now being made visible to GPs and other primary care prescribers in OptimiseRx. This is through a national partnership between FDB, the leading provider of drug knowledge for healthcare professionals, and the University of Nottingham’s PRIMIS team, who are leading on the national roll-out of the PINCER intervention in partnership with the national network of Academic Health Science Networks.

The OptimiseRx technology’s overall focus is helping GPs and other prescribers make decisions that comply with local and national prescribing priorities. This includes alerting them when more cost-effective alternatives are available, and by providing patient-specific prescribing recommendations based on the patient’s record to ensure safe and effective prescribing.

Kerry Oliver, managing director of PRIMIS, said: “The agreement to embed the PINCER indicators in OptimiseRx provides enormous reach for what will be of vital benefit to key prescribing decisions within thousands of practices throughout England.

“Including them in such a widely used medicines management system will be an important factor for the sustainability of the PINCER indicators, emphasising their role in evolving knowledge and processes that help to prevent medication errors from recurring.”

Darren Nichols, UK managing director at FDB, said: “Our national partnership with PRIMIS is a crucial development in our providing GP practices with the necessary guidance and support to ensure they are alerted to potentially hazardous prescribing.

“We have listened to clinical commissioners and prescribers across the country who see the inclusion of the latest PINCER indicators within OptimiseRx as an important component of their adoption of national policies for helping to safeguard patients.

“Every day thousands of GP practices already draw on alerts within the technology to help them make the best prescribing decisions for patients, with primary care professionals prompted when best practice might indicate there could be better alternatives for patients. This important upgrade to the system with additional indicators will make those prompts even more comprehensive.”

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