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Updated: Oct 17, 2025

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Implementing prescribing safety indicators in prisons: A mixed methods study.

Aseel S Abuzour1,2, Esnath Magola-Makina1,2, James Dunlop2

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British Journal of Clinical Pharmacology
|October 9, 2021
PubMed
Summary
This summary is machine-generated.

Prescribing safety indicators (PSIs) were implemented in prisons to identify hazardous prescribing. These tools can improve medication safety when integrated into healthcare workflows and supported by staff.

Keywords:
electronic health recordsmedication safetypatient safetyprescribingprescribing safety indicatorsprison health

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Area of Science:

  • Pharmacology
  • Public Health
  • Health Services Research

Background:

  • Potentially hazardous prescribing is a significant concern in correctional facilities.
  • Prescribing Safety Indicators (PSIs) offer a systematic method for evaluating medication safety.

Purpose of the Study:

  • To assess the prevalence of potentially hazardous prescribing in prisons using PSIs.
  • To explore the practical implementation and utility of PSIs within the prison healthcare setting.

Main Methods:

  • PSIs were developed through literature review and expert consensus.
  • Pharmacists deployed PSIs using electronic health record search protocols at two prison sites.
  • Semi-structured interviews were conducted with 20 prison healthcare staff to evaluate feasibility and gather implementation insights.

Main Results:

  • Thirteen PSIs were deployed, primarily focusing on drug-drug interactions.
  • Elevated prevalence rates were observed for specific indicators, including anticholinergic use in the elderly, antipsychotic monitoring gaps, prolonged hypnotic use, and concurrent NSAID/antiplatelet use without gastroprotection.
  • Prison healthcare staff endorsed PSI use and highlighted the importance of staff engagement and designated champions for successful implementation.

Conclusions:

  • A suite of PSIs was successfully implemented in two prisons, identifying areas for targeted intervention.
  • PSI implementation can enhance prescribing safety in prisons when adequately resourced and integrated into clinical workflows.