Medication errors are common in primary care and are associated with considerable risk of patient harm. The PINCER intervention is an effective method for reducing a range of medication errors in general practices with computerised clinical records and is more effective than simple feedback (Avery et al 2012). The PINCER queries are a set of computerised queries that are run on GP clinical systems to identify ‘at-risk’ patients who are being prescribed drugs commonly associated with medication errors.
This exploratory project in Newcastle was undertaken to help gain an understanding of what is involved in actually using the PINCER tool, and to use this tool to identify patients at risk of medication errors and take action to reduce these risks. A pharmacist has been employed specifically to undertake this project for 6 months. The project pharmacist worked with the prescribing lead, practice manager and other practice staff along with practice support pharmacists, installing and running the software, and then identifying, reviewing and making recommendations on the most appropriate action for at risk patients. The project pharmacist discussed the results with the prescribing lead and practice manager and supported both to carry out recommendations as deemed necessary. Any recommendations with regards to change in practice were also discussed. The project has underway for 4 months now, with the PINCER query having been run in 29 out of 35 practices in Newcastle. A final report will be available following completion of the project which is expected to be at the end of September 2015.
NECS are developing a prescribing safety dashboard within RAIDR, expected to be live by mid-August, which will identify patients at risk of medication events. This will enable analysis of data at a CCG level and practices can further investigate patients at a practice level. The medicines optimisation practice team will support practices to follow up patients identified ‘at risk’ and target medication reviews in these patients as appropriate.
Avery A J, Rodgers S, Cantrill J A et al (2012). A pharmacist-led information technology intervention for medication errors (PINCER): A multicentre, cluster randomised, controlled trial and cost-effectiveness analysis. The Lancet, 379(9823), 1310–1319.