Instances of potentially hazardous prescribing in general practice Not Applicable Hazardous prescribing
Conditions
Interventions
Practices will be stratified by centre (Manchester or Nottingham) and size of practice. They will then be randomly allocated within strata to either the pharmacist intervention arm of the study or sim
Sponsors
Patient Safety Research Programme of the Department of Health (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. NHS general practices within a 50 mile radius of Manchester and Nottingham in England 2. Practices within Primary Care Trusts (PCTs) that agree to be involved in the study 3. Practices that have been laboratory-linked (or have other reliable systems for recording blood test results on the practice computer system) for at least 15 months prior to the time of baseline data collection 4. Practices that agree to participate in the study;Inclusion criteria: 1. NHS general practices within a 50 mile radius of Manchester and Nottingham in England 2. Practices within Primary Care Trusts (PCTs) that agree to be involved in the study 3. Practices that have been laboratory-linked (or have other reliable systems for recording blood test results on the practice computer system) for at least 15 months prior to the time of baseline data collection 4. Practices that agree to participate in the study
Exclusion criteria
Exclusion criteria: 1. Practices that state they do not routinely record morbidity such as asthma or peptic ulcer on the computer 2. Practices that do not use their computers to record prescriptions 3. Practices intending to change their General Practice (GP) computer systems to that of a different supplier which is not Quest Browser compatible during the course of the study 4. Practices in PCTs that are undertaking interventions that might overlap with our intervention 5. Practices that were involved in our pilot study 6. Practices that do not agree to the installation of Quest Browser software on their practice computers (this software is essential for generating patient-specific data on patients with medication errors) 7. Practices that expect major changes in list size during the course of the study, either because of the splitting up of the practice, merger with other practices or any other reason for a large influx or loss of patients;Exclusion criteria: 1. Practices that state they do not routinely record morbidity such as asthma or peptic ulcer on the computer 2. Practices that do not use their computers to record prescriptions 3. Practices intending to change their General Practice (GP) computer systems to that of a different supplier which is not Quest Browser compatible during the course of the study 4. Practices in PCTs that are undertaking interventions that might overlap with our intervention 5. Practices that were involved in our pilot study 6. Practices that do not agree to the installation of Quest Browser software on their practice computers (this software is essential for generating patient-specific data on patients with medication errors) 7. Practices that expect major changes in list size during the course of the study, either because of the splitting up of the practice, merger with other practices or any other reason for a large influx or loss of patients
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The proportion of patients in each practice: 1. Aged 18 years and older with a computer-recorded history of peptic ulcer being prescribed non-selective Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in the previous six months without receiving drugs to protect against further peptic ulcer 2. Aged 18 years and older with a computer-recorded diagnosis of asthma being prescribed beta-blockers in the previous six months 3, Aged 75 years and older receiving long-term prescriptions for Angiotensin Converting Enzyme (ACE) inhibitors or loop diuretics without a recorded assessment of renal function and electrolytes in the previous 15 months The proportions of "at risk" patients in each treatment arm with the errors of interest will be compared between treatment arms at six and 12 months after the end of the intervention period in each practice (the primary analysis will be undertaken using the six-month follow-up data).;The proportion of patients in each practice: 1. Aged 18 years and older with a computer-recorded history of peptic ulcer being prescribed non-selective Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in the previous six months without receiving drugs to protect against further peptic ulcer 2. Aged 18 years and older with a computer-recorded diagnosis of asthma being prescribed beta-blockers in the previous six months 3, Aged 75 years and older receiving long-term prescriptions for Angiotensin Converting Enzyme (ACE) inhibitors or loop diuretics without a recorded assessment of renal function and electrolytes in the previous 15 months The proportions of "at risk" patients in each treatment arm with the errors of interest will be compared between treatment arms at six and 12 months after the end of the intervention period in each practice (the primary analysis will be undertaken using the six-month follow-up data). | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary outcome measures relate to a range of potential problems in the prescribing and monitoring of the following drugs: 1. Combined hormonal contraceptives 2. Warfarin 3. Lithium 4. Methotrexate 5. Amiodarone The proportions of "at risk" patients in each treatment arm with the errors of interest will be compared between treatment arms at six and 12 months after the end of the intervention period in each practice (the primary analysis will be undertaken using the six-month follow-up data).;Secondary outcome measures relate to a range of potential problems in the prescribing and monitoring of the following drugs: 1. Combined hormonal contraceptives 2. Warfarin 3. Lithium 4. Methotrexate 5. Amiodarone The proportions of "at risk" patients in each treatment arm with the errors of interest will be compared between treatment arms at six and 12 months after the end of the intervention period in each practice (the primary analysis will be undertaken using the six-month follow-up data). | — |
Countries
United Kingdom
Contacts
Public Contact; ;
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Outcome results
None listed