Australian primary healthcare professionals are a step closer to having an evidence-based guide to safer prescribing – designed to reduce medication harm and ease the burden on the national healthcare system.
Researchers from Monash University, alongside a broad consortium of national and international partners, have developed 23 Quality Prescribing Indicators. These indicators act as a clinical compass to guide safe and appropriate prescribing for common health conditions in all adults in primary care across Australia.
Medication-related problems place a substantial cost burden on hospitals through preventable admissions, and while quality prescribing indicators offer a proven way to evaluate and improve medicine use, Australia has lacked an updated, nationally recognised set for primary care since 2006. Research published today in the journal BMJ Quality & Safety intends to change that.
Senior author of the research Associate Professor Johnson George, from the Centre for Medicine Use and Safety (CMUS) at the Monash Institute of Pharmaceutical Sciences (MIPS), said the new framework is a critical step forward for patient safety and clinical practice.
“This study provides Australia with a validated set of 23 prescribing indicators that can be used to guide gold-standard prescribing in primary care, by all health professionals,” Associate Professor George said.
“Developed and endorsed by an expert panel of general practitioners, nurse practitioners and pharmacists and the professional bodies, these indicators offer a practical way to identify potentially inappropriate prescribing, monitor practices and support improvements in the safe and effective use of medicines.”
The approved indicators provide vital information on the appropriate initiation of medicines, ongoing monitoring, avoiding high-risk prescribing combinations and deprescribing when medications are no longer necessary.
They cover seven major therapeutic areas, including proton pump inhibitors, vaccinations, blood pressure medications, anti-inflammatories, asthma inhalers, mental health treatments and pain relief.
Second author of the study Anna Mackintosh, the Project Manager at MIPS for the Medical Research Future Fund (MRFF) project APRICOT, said the research lays the groundwork for changes that could have a real impact on the safety of prescribing in Australian primary care, with the indicators set to be tested in an upcoming randomised controlled trial.
“We developed these indicators to help guide safe and appropriate prescribing for common health conditions,” Ms Mackintosh said.
“If our indicators are adopted widely, they could help healthcare professionals prescribe medicines more safely in primary care. Over time, this could reduce medication-related harms, prevent avoidable hospital admissions, lower healthcare costs and ultimately improve patient outcomes.”
The next phase of the research, part of the broader $4 million MRFF APRICOT project, will involve a randomised controlled trial, testing the indicators in primary care clinics alongside an educational audit, feedback and other strategies to support and enhance medication safety.
The research has been a collaborative effort from first author Dr James Nind and colleagues from Monash University, University of Tasmania and the University of Sydney.
The APRICOT project includes an extensive network of partner organisations: Monash University, CSIRO, University of Tasmania, The University of Sydney, The University of Newcastle, The University of Melbourne, Consumers Health Forum of Australia, Flinders University, University College Dublin, North West Melbourne PHN, Western Victoria PHN, the Pharmaceutical Society of Australia (PSA), Royal Australian College of General Practitioners (RACGP) and the Australian Primary Care Nurses Association (APNA).
Read the research paper: doi.org/10.1136
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