Quality improvement: prescribing and patient safety reportsPublished: 2nd September 2019
The RCGP and Clinical Practice Research Datalink (CPRD) have developed confidential bespoke practice and patient-level drug prescribing reports, available for free for GP practices contributing to CPRD.
There are two sets of reports, distributed every six months to practices in all four nations of the UK. As the reports are based on the CPRD data extract, practices that are not already in the CPRD network will need to sign up by completing the application form on the CPRD website.
Sodium valproate prescribing data report
Sodium valproate prescription for women of childbearing age is a patient safety priority for the MHRA. There is a particular focus on this in the 2019/20 QOF Prescribing Safety module of the Quality Improvement domain – addressing the issue can help with QOF points. The data reports will highlight all women of childbearing age with a valproate prescription in your practice. They will also include guidance and support material for use with patients.
Valproate is prescribed for epilepsy and bipolar disorder, but it is associated with a significant risk of birth defects and developmental disorders in children born to women who take valproate during pregnancy. Current advice from the MHRA is that valproate must not be used in any woman or girl able to have children unless there is a pregnancy prevention programme (PPP) in place, including the completion of a signed risk acknowledgement form.
There is a ban on the use of valproate for migraine or bipolar disorder during pregnancy, and a ban on the use of valproate to treat epilepsy during pregnancy unless there is no other effective treatment available. Earlier this year, the RCGP published a guidance document for clinicians on valproate use.
Heart and Circulatory System data report
The Heart and Circulatory System report includes three indicators taken from the RCGP patient safety toolkit and one that was suggested by NICE:
- Prescription of glitazones to patients with heart failure
- Prescription of NSAIDs to patients with heart failure
- Prescription of NSAIDs to patients with chronic kidney disease (CKD)
- Aspirin monotherapy for stroke prevention in patients with atrial fibrillation
Learning Disabilities data report
The Learning Disabilities report includes indicators developed from the Stopping over medication of people with a learning disability, autism or both (STOMP) project:
- Prescription of anti-psychotics to over-16s with Learning Disabilities and/or Autism
- Prescription of anti-depressants to over-16s with Learning Disabilities and/or Autism
Examples of how the CPRD data reports are being used by practices
Dr Tommy Hunter has written a blog on how he has used the reports as part of his work to improve outcomes for patients within his practice.
David Mullett, the RCGP Champion for this project, has written a blog about how the project uses patient data to improve patient safety for Understanding Patient Data, which is aimed at patients and the public.
In the videos below, Dr Scott Jamieson, RCGP Scotland Quality Improvement lead, provides an overview of the data reports and how they can be used by practices.