Dashboards to reduce inappropriate prescribing of metformin and aspirin: a quality assurance programme in a primary care sentinel network
<p><strong>Aims</strong></p> To pilot two dashboards to monitor prescribing of metformin and aspirin according to the National Institute for Health and Care Excellence (NICE) ‘Do-Not-Do’ recommendations. <p><strong>Methods</strong></p> This quality as...
| Main Authors: | , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2021
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| _version_ | 1797107031281238016 |
|---|---|
| author | de Lusignan, S Hinton, W Seidu, S Mathew, M Feher, MD Munro, N Joy, M Carinci, F Hobbs, FDR Khunti, K |
| author_facet | de Lusignan, S Hinton, W Seidu, S Mathew, M Feher, MD Munro, N Joy, M Carinci, F Hobbs, FDR Khunti, K |
| author_sort | de Lusignan, S |
| collection | OXFORD |
| description | <p><strong>Aims</strong></p>
To pilot two dashboards to monitor prescribing of metformin and aspirin according to the National Institute for Health and Care Excellence (NICE) ‘Do-Not-Do’ recommendations.
<p><strong>Methods</strong></p>
This quality assurance programme was conducted in twelve general practices of the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network. We developed dashboards to flag inappropriate prescribing of metformin and aspirin to people with type 2 diabetes mellitus (T2DM). In Phase 1, six practices (Group A) received a dashboard flagging suboptimal metformin prescriptions in people with reduced renal function. The other six practices (Group B) were controls. In Phase 2, Group B were provided a dashboard to flag inappropriate aspirin prescribing and Group A were controls. We used logistic regression to explore associations between dashboard exposure and inappropriate prescribing.
<p><strong>Results</strong></p>
The cohort comprised 5644 individuals (Group A, n = 2656; Group B, n = 2988). Half (51.6%, n = 2991) were prescribed metformin of which 15 (0.5%) were inappropriate (Group A, n = 10; Group B, n = 5). A fifth (17.6%, n = 986) were prescribed aspirin of which 828 (84.0%) were inappropriate. During Phase 1, metformin was stopped in 50% (n = 5) of people in Group A, compared with 20% (n = 1) in the control group (Group B); in Phase 2, the odds ratio of inappropriate aspirin prescribing was significantly lower in practices that received the dashboard versus control (0.44, 95%CI 0.27−0.72).
<p><strong>Conclusions</strong></p>
It was feasible to use a dashboard to flag inappropriate prescribing. Whilst underpowered to report a change in metformin, we demonstrated a reduction in inappropriate aspirin prescribing. |
| first_indexed | 2024-03-07T07:10:48Z |
| format | Journal article |
| id | oxford-uuid:6dd0f8a3-3a9a-40e6-b96d-f5bf64e0e6ef |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:10:48Z |
| publishDate | 2021 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:6dd0f8a3-3a9a-40e6-b96d-f5bf64e0e6ef2022-06-17T09:40:26ZDashboards to reduce inappropriate prescribing of metformin and aspirin: a quality assurance programme in a primary care sentinel networkJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6dd0f8a3-3a9a-40e6-b96d-f5bf64e0e6efEnglishSymplectic ElementsElsevier2021de Lusignan, SHinton, WSeidu, SMathew, MFeher, MDMunro, NJoy, MCarinci, FHobbs, FDRKhunti, K<p><strong>Aims</strong></p> To pilot two dashboards to monitor prescribing of metformin and aspirin according to the National Institute for Health and Care Excellence (NICE) ‘Do-Not-Do’ recommendations. <p><strong>Methods</strong></p> This quality assurance programme was conducted in twelve general practices of the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network. We developed dashboards to flag inappropriate prescribing of metformin and aspirin to people with type 2 diabetes mellitus (T2DM). In Phase 1, six practices (Group A) received a dashboard flagging suboptimal metformin prescriptions in people with reduced renal function. The other six practices (Group B) were controls. In Phase 2, Group B were provided a dashboard to flag inappropriate aspirin prescribing and Group A were controls. We used logistic regression to explore associations between dashboard exposure and inappropriate prescribing. <p><strong>Results</strong></p> The cohort comprised 5644 individuals (Group A, n = 2656; Group B, n = 2988). Half (51.6%, n = 2991) were prescribed metformin of which 15 (0.5%) were inappropriate (Group A, n = 10; Group B, n = 5). A fifth (17.6%, n = 986) were prescribed aspirin of which 828 (84.0%) were inappropriate. During Phase 1, metformin was stopped in 50% (n = 5) of people in Group A, compared with 20% (n = 1) in the control group (Group B); in Phase 2, the odds ratio of inappropriate aspirin prescribing was significantly lower in practices that received the dashboard versus control (0.44, 95%CI 0.27−0.72). <p><strong>Conclusions</strong></p> It was feasible to use a dashboard to flag inappropriate prescribing. Whilst underpowered to report a change in metformin, we demonstrated a reduction in inappropriate aspirin prescribing. |
| spellingShingle | de Lusignan, S Hinton, W Seidu, S Mathew, M Feher, MD Munro, N Joy, M Carinci, F Hobbs, FDR Khunti, K Dashboards to reduce inappropriate prescribing of metformin and aspirin: a quality assurance programme in a primary care sentinel network |
| title | Dashboards to reduce inappropriate prescribing of metformin and aspirin: a quality assurance programme in a primary care sentinel network |
| title_full | Dashboards to reduce inappropriate prescribing of metformin and aspirin: a quality assurance programme in a primary care sentinel network |
| title_fullStr | Dashboards to reduce inappropriate prescribing of metformin and aspirin: a quality assurance programme in a primary care sentinel network |
| title_full_unstemmed | Dashboards to reduce inappropriate prescribing of metformin and aspirin: a quality assurance programme in a primary care sentinel network |
| title_short | Dashboards to reduce inappropriate prescribing of metformin and aspirin: a quality assurance programme in a primary care sentinel network |
| title_sort | dashboards to reduce inappropriate prescribing of metformin and aspirin a quality assurance programme in a primary care sentinel network |
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