RPS Conference 2010, Abstracts 2010 - Royal Pharmaceutical Society

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eductions in proportions of patients at risk of prescribing and monitoring errors in general practice. Reference: 1 Avery AJ et al Protocol for the PINCER trial: a cluster randomised trial comparing the effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices Trials 2009:10:28
4 How pharmacists working on the PINCER trial helped reduce hazardous prescribing Rachel Howard 1 , Anthony Avery 2 , Judith Cantrill 3 1 University of Reading, Reading, United Kingdom, 2 University of Nottingham, Nottingham, United Kingdom, 3 University of Manchester, Manchester, United Kingdom Focal Points • The objective of this study was to describe the actions recommended and completed by pharmacists to help reduce hazardous medicines management in primary care as part of the PINCER trial • Pharmacists recommended 2118 actions in 75% (1518/2038) of cases of hazardous medicines management identified in the PINCER trial; 66% (1388) of recommendations were accepted by general practitioners • The high percentage of pharmacists’ recommendations accepted by general practitioners suggests that the pharmacist intervention implemented in the PINCER trial was broadly acceptable to general practices. Introduction The PINCER trial 1 has demonstrated the effectiveness of a complex pharmacist-led IT-based intervention compared to simple feedback in reducing the proportion of patients potentially at risk from hazardous medicines management in general practice. Patients potentially at risk of harm were identified by automated computer searches based on 10 outcome measures describing different types of hazardous medicines management, such as: prescribing betablockers to patients with a history of asthma, not monitoring INRs at least every three months in patients taking oral anticoagulants, and not stating that methotrexate should be taken weekly. In the intervention arm of the trial, medical records of patients identified by the computer searches were reviewed by trained pharmacists. These pharmacists used their clinical knowledge and experience to judge whether patients were at risk of harm from hazardous medicines management. Where patients were considered at risk they made recommendations and implemented changes agreed with general practitioners. The objective of this study was to describe the recommendations made and changes implemented for individual patients as part of the PINCER trial 1 . Method Pharmacists recorded details of their recommendations to general practitioners, actions subsequently taken to reduce risk of harm to patients, and the time taken. Summary data describing pharmacists’ interventions as part of the PINCER trial and demographic data for patients and general practices were entered into SPSS v15; entries were double checked for accuracy. Data were analysed using descriptive statistics. Results 1946 patients were identified as potentially at risk from hazardous medicines management in 2038 cases (92 patients were identified by 2 outcome measures) by the computer searches. 1465/2026 (72.2%) of these cases were judged to be at clinical risk of harm by the pharmacists. The percentage of at risk cases varied markedly between outcome measures (from 23.5% to 93.8%). Pharmacists recommended 2118 actions in 1518/2038 (74.5%) of cases identified by the electronic searches. Pharmacists’ recommendations were tailored to the outcome measures and individual patients. General practitioners accepted 1388 (65.5%) of pharmacists’
Page 1 and 2: 1 Cost effectiveness of community p
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Page 21 and 22: 11 Over-the-counter simvastatin: co
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Page 29 and 30: 15 Training undergraduate pharmacy
Page 31 and 32: 16 ‘You’re an agent unto yourse
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Page 35 and 36: 18 The Role of the Pharmacist and E
Page 37 and 38: 19 Exploring patient opinions of MU
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Page 43 and 44: 22 The HAPPY trial: a randomised co
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29 Defining and identifying perform
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30 Engendering and Appraising ‘Pr
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31 Inappropriate prescribing of Opi
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32 Developing a five-year curriculu
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33 An Investigation of the incidenc
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34 Analysing medicine wastage in th
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35 A Clinical Audit on the Use of A
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36 A Clinical Audit on Reporting an
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37 Assessment of hypertension care
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38 Community pharmacy EHC services:
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39 The Impact of the Lloyds Pharmac
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40 Medication and handover incident
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41 The time-scale for delivery of p
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42 Medication access in primary car
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43 A solution to improving uptake o
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44 Medicines Information to Support
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45 Are pharmacist public health pra
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46 Anticoagulation for haemofiltrat
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47 Med Wreck: An Audit of Communica
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48 Pandemic flu preparedness: Plann
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49 Young people's views about chlam
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50 Psychotropic use in elderly pati
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51 Using simulation of community ph
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52 ‘Pharmacists in Schools’: De
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53 What do Pharmacists in Surrey wa
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54 Has the new audit module in the
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55 Introduction of a Nursing Home B
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56 An audit of Benzodiazepine presc
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57 Improving patient safety through
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58 Video clips enhance student lear
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59 Do preregistration trainee pharm
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60 An investigation of the views of
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61 Ensuring accuracy in routinely c
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62 Deprivation status and utilizati
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63 Exploring Reasons, Factors and A
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64 I’m off to the gym: Exploring
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65 Is there alignment between the v
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66 The views of out-patients with c
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67 Patient Experiences of Living wi
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68 Clinical management and cost of
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69 Medicines Use Reviews - how have
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70 How are pharmacists, registered
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71 Barriers facing hypertensive pat
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72 Developing an RCT of general pra
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73 User and Staff Perspectives of C
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74 Impact of pandemic influenza A/H
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75 How do patients with osteoporosi
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76 Integrating tuberculosis and dia
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77 Improving outcomes and quality o
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78 The uncertain future: a pilot st
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79 Linkage of routinely collected N
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80 Impact of Formative Assessment o
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81 The prevalence of pharmacists’
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82 A comparative study of prescribi
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83 Evaluation of patient informatio
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84 Patient medication adherence: a
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85 Fitness to practise: pharmacists
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86 Measurement of empathy levels in
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87 Benzyl Alcohol Exposure from Hep
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88 Neonatal gentamicin infusions- W
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89 Unlicensed and off-label use of
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90 Unlicensed and off-label prescri
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91 Exploring community pharmacists
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92 Investigation into Rapid Microbi
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93 Pharmacy prescribing in XXXX-a q
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94 Pharmacy prescribing in XXXX-a q
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95 MEDICINE RELATED PROBLEMS IN SOU
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96 Stability of pharmaceutical prod
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97 The experiences of Malaysian pha
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98 Medication management in older p
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99 Adherence with calcium and vitam
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100 Appraisal systems within commun
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101 The clinical impact of a fractu
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102 An audit of primary care prescr
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103 Views of the public on over-the
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RPS Conference 2010, Abstracts 2010 - Royal Pharmaceutical Society

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