Quality improvement of prescribing safety: a pilot study in primary care using UK electronic health records

Sam Kosari; Louise S Deeks; John Goss; Mark Naunton

doi:10.3399/bjgp19X705725

We agree with Booth et al¹ that pharmacists in general practice could have an important role in actioning reports from electronic health records. We look forward to the impact evaluation that will assess alterations in prescribing because of this initiative.

In addition to identifying potentially unsafe prescribing, interrogation of electronic health records can also be used to identify patients who are not prescribed appropriate medication for their condition, and are at risk of harm through untreated disease. We have previously reported about the activities of general practice pharmacists in Canberra, Australia,² one of whom conducted an audit using electronic health records to identify patients diagnosed with atrial fibrillation (AF) in a single general practice during 2016. Three untreated patients were identified: if they had been treated with warfarin, this would have saved them 1.38 years of life and prevented 0.56 strokes over 5 years.³ The total value of the intervention was estimated to be $157 360 ($28 620–$244 310) over 5 years (adjusted to 2016 values when the intervention occurred) [calculated by the author from Australian Institute of Health and Welfare data].⁴^,⁵

Our findings support the regular interrogation of general practice electronic health records, not only to improve patient safety but also to contribute to the sustainability of health provision.

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