Preventing drug related morbidity: a process for facilitating changes in practice

Area of Science:

• Health Services Research
• Pharmaceutical Policy
• General Practice Informatics

Background:

• Medicines management in general practice is crucial for patient safety.
• Preventable drug-related morbidity (PDRM) indicators offer a quantitative approach to identify areas for improvement.
• Electronic patient records (EPRs) provide a rich source of data for PDRM indicator application.

Purpose of the Study:

• To evaluate the utility of EPR-derived PDRM indicator data in facilitating improvements in medicines management within English general practices.
• To explore how multidisciplinary teams utilize this data to identify and address medication-related issues.

Main Methods:

• A qualitative study involving eight English general practices.
• Data collection through multidisciplinary discussion forums facilitated by clinical researchers.
• Monitoring practice progress on identified issues at 1, 3, and 6 months post-intervention.

Main Results:

• Practices successfully identified and addressed straightforward clinical issues, such as reviewing specific patient cohorts.
• System-level improvements in medicines management were less frequently implemented.
• The process stimulated practice-wide discussions on medication safety and management.

Conclusions:

• Quantitative PDRM indicator data can effectively drive discussions and targeted actions in medicines management.
• Practice-level ownership and the presence of a dedicated lead are critical success factors for implementing changes.
• The approach highlights varying priorities among practices in addressing identified medication-related issues.