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Evaluation of a pharmacist-led actionable audit and feedback intervention for improving medication safety in UK primary care: An interrupted time series analysis

Author

Listed:
  • Niels Peek
  • Wouter T Gude
  • Richard N Keers
  • Richard Williams
  • Evangelos Kontopantelis
  • Mark Jeffries
  • Denham L Phipps
  • Benjamin Brown
  • Anthony J Avery
  • Darren M Ashcroft

Abstract

Background: We evaluated the impact of the pharmacist-led Safety Medication dASHboard (SMASH) intervention on medication safety in primary care. Methods and findings: SMASH comprised (1) training of clinical pharmacists to deliver the intervention; (2) a web-based dashboard providing actionable, patient-level feedback; and (3) pharmacists reviewing individual at-risk patients, and initiating remedial actions or advising general practitioners on doing so. It was implemented in 43 general practices covering a population of 235,595 people in Salford (Greater Manchester), UK. All practices started receiving the intervention between 18 April 2016 and 26 September 2017. We used an interrupted time series analysis of rates (prevalence) of potentially hazardous prescribing and inadequate blood-test monitoring, comparing observed rates post-intervention to extrapolations from a 24-month pre-intervention trend. The number of people registered to participating practices and having 1 or more risk factors for being exposed to hazardous prescribing or inadequate blood-test monitoring at the start of the intervention was 47,413 (males: 23,073 [48.7%]; mean age: 60 years [standard deviation: 21]). At baseline, 95% of practices had rates of potentially hazardous prescribing (composite of 10 indicators) between 0.88% and 6.19%. The prevalence of potentially hazardous prescribing reduced by 27.9% (95% CI 20.3% to 36.8%, p

Suggested Citation

  • Niels Peek & Wouter T Gude & Richard N Keers & Richard Williams & Evangelos Kontopantelis & Mark Jeffries & Denham L Phipps & Benjamin Brown & Anthony J Avery & Darren M Ashcroft, 2020. "Evaluation of a pharmacist-led actionable audit and feedback intervention for improving medication safety in UK primary care: An interrupted time series analysis," PLOS Medicine, Public Library of Science, vol. 17(10), pages 1-17, October.
    • Handle: RePEc:plo:pmed00:1003286
    DOI: 10.1371/journal.pmed.1003286
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    References listed on IDEAS

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    1. Evangelos Kontopantelis & David A Springate & David Reeves, 2013. "A Re-Analysis of the Cochrane Library Data: The Dangers of Unobserved Heterogeneity in Meta-Analyses," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-14, July.
    2. Ariel Linden, 2015. "Conducting interrupted time-series analysis for single- and multiple-group comparisons," Stata Journal, StataCorp LP, vol. 15(2), pages 480-500, June.
    3. Evangelos Kontopantelis & David Reeves, 2010. "metaan: Random-effects meta-analysis," Stata Journal, StataCorp LP, vol. 10(3), pages 395-407, September.
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