Using data to improve patient safety

Image of computer with graphs and data

13 September 2019

David Mullett, RCGP Champion for Quality Improvement and Patient Safety

Routinely collected data may not be the first tool you think of in relation to improving patient safety, but it is an invaluable resource.

The RCGP and Clinical Practice Research Datalink (CPRD) Quality Improvement collaboration uses routinely collected data to provide prescribing and patient safety reports to practices across the UK who are signed up to the CPRD data extract. The reports include benchmarking and case-finding, as well as support material outlining recommended next steps.

There are currently two sets of reports:

  • One covers the prescription of psychotropic drugs to patients with a learning disability or autism or both. This patient group suffers from significantly worse health outcomes than the general population. On average, females with learning disabilities have around an 18-year shorter life expectancy than the general population, and males have around a 14-year shorter life expectancy than the general population. GPs use the reports as a prompt around the safe prescribing of anti-depressants and anti-psychotics, and to make sure that patients are given regular health checks to mitigate the physical side effects of these drugs.
  • The heart and circulatory system report, which GPs use to review and adjust the treatment of individual patients, for instance, the prescription of non-steroidal anti-inflammatory drugs (NSAIDs) to patients with heart failure or chronic kidney disease, or stroke prevention in patients with atrial fibrillation.

Data will contribute to the MHRA’s monitoring of drug safety

This autumn we will be adding another report: prescription of sodium valproate to women of childbearing age. The data reports will highlight all women of childbearing age with a valproate prescription in your practice and will also include guidance and support material for use with patients. Sodium valproate prescription for women of childbearing age is a patient safety priority for the MHRA and the UK’s Chief Pharmaceutical Officers; for English practices, there is a particular focus on this in the 2019-20 QOF Prescribing Safety module of the Quality Improvement domain

Valproate prescription illustrates the public health benefit of signing your practice up to the CRPD data extract. As well as receiving the reports, your patients’ data will contribute to the MHRA’s monitoring of drug safety. As part of its work, the MHRA has been using the CPRD dataset to monitor trends in the prescribing of valproate, in order to assess the impact of evolving regulatory recommendations and introduction of the pregnancy prevention programme.  

The CPRD dataset is also used for a range of patient safety research projects. Research using CPRD data showed that administering the pertussis vaccine in pregnancy is safe, that there is no link between MMR and autism and that influenza vaccination was associated with a reduction in the rate of hospital admissions for acute cardiovascular and respiratory disease and a reduction in all-cause mortality.

 The quality improvement reports are free to all practices that contribute data to CPRD in England, Wales, Scotland and Northern Ireland. Because the reports are based on the CPRD data extract, practices that are not already in the CPRD network will need to sign up by completing the application form on the CPRD website (Please tick the box ‘RCGP/quality improvement’ under ‘How did you hear about us?’ on the joining form.)

For more information please contact the RCGP Project Champion, David Mullett, at David.Mullett@rcgp.org.uk; @dmmullett on Twitter. 

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