Patient safety and prescribing - Do you have all the information you need?

David Mullett, RCGP Project Lead for CPRD

Clinicians from across the UK have been using practice-level reports from the RCGP and CPRD to review their prescribing safety. The reports were produced during the pilot stage of a quality improvement project that focuses on prescribing and patient safety. The pilot stage has now come to an end, and all practices in the UK can now sign up to receive their report. See an example report here.

During the pilot phase of the project, participants were sent practice-level reports showing data for two indicators from the RCGP’s Patient Safety Toolkit:

  • Prescription of NSAIDs to patients with heart failure
  • Prescription of glitazone to patients with heart failure

The reports showed the practice’s prescription rate benchmarked against all practices in the CPRD network, plus pseudonymised identifiers to enable re-identification of patients whose care might need review. The reports also included recommendations for next steps, based on NICE guidance, and links to further information.

Participating clinicians have used the reports to review the care of individual patients in the following ways:

  • The records of all patients identified in the reports were reviewed.
  • Repeat prescriptions were inactivated and patients were asked to make an appointment to discuss their treatment.
  • The risks of their current prescriptions were discussed with patients, together with possible alternatives.
  • With their consent, patients were prescribed alternative treatments.

Participants also used the reports for wider quality improvement work within their practices:

  • The records of all heart failure patients were flagged with a reminder that they should not be prescribed NSAIDs or glitazones.
  • The reports were used as the starting-point for discussions involving all clinicians within the practice around safe prescribing.

At least one participant has used this review process as evidence for his annual appraisal, under Domain 2 – Safety and Quality.

Feedback from the pilot stage of the project was very positive, with all participants who responded saying that they found the reports useful and helpful. The pilot phase has therefore come to an end and over the course of the year the reports will be rolled out free of charge to practices across the country. The focus will continue to be on helping GPs to improve the quality of the services for patients by making optimal use of routinely collected data. The intention is to include more indicators from the toolkit in future versions of the report, based on what clinicians say would be most useful for them.

The reports are based on the CPRD data extract, so to receive the report for your practice you will need to sign up by completing the application form on the CPRD website. For more information, contact the RCGP project lead David Mullett.

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