Safety and Quality: Prescribing
How to Analyse the Data
Once you have got your data, you need to decide how accurately it reflects your prescribing, how comparable your data is with the average, and how your prescribing compares with other colleagues.
Long term medication accounts for around 90% of all prescribing costs, and the majority derives from the BNF Sections 1-4 (G-I, CVS, RS and CNS). Hospital policies may influence the drugs used: you may find that long term prescribing assigned to your cipher has been initiated by somebody else.
Conversely you will initiate most of the acute prescriptions on your own cipher: but whilst these are usually large numbers of short drug courses, they may have a smaller impact on costs but a larger impact on other issues such as antibiotic resistance.
Asking yourself the following questions should help you to decide.
Why did you choose this data source?
How accurately does it reflect your prescribing?
How does your prescribing compare with that of your Practice as a whole?
How does your prescribing compare with your CHP as a whole?
Is there a category or class about which further evaluation would be worthwhile? Why?
What outcome would you like to achieve?
For the category or class that you have chosen to study in detail, we have suggested that you utilise the following structure for your analysis. (We have given some examples, and a template to help structure your analysis.)
Dr A looked at his SPA 1 data, and noticed that his gastrointestinal drugs were costing more than the average GP. He felt that his data did reasonably reflect his prescribing, and there were no special reasons to explain this. He therefore requested a PRISMS report, which suggested that he was prescribing a greater number of items in the proton pump inhibitor group than the average. He should now:
Dr B, working for the out-of-hours service, prescribed co-amoxiclav for a chest infection in his patient. She subsequently developed an adverse drug reaction, becoming jaundiced. Dr B checked back through his consultations for his last 2 shifts, noting which antibiotics he had used. He should now:
Dr C had a patient who called one morning having fallen. On reviewing her medication Dr C was surprised to find that she had been taking diazepam regularly since the death of her husband some months previously. He discussed this with his team, and they supported his decision of auditing repeat requests for benzodiazepines. He should now:
Dr D's prescribing adviser pointed out that his cardiovascular drug costs were particularly high. She suggested a PRISMS search, which demonstrated that statin prescribing costs were above the local and national average, although he had no excess of patients with either vascular disease or diabetes. The data further suggested that he was prescribing above average amounts of atorvastatin 10mg. He should now:
This page was last updated on: 15/05/2015
© 2013 - NHS Education for Scotland