New analysis of drug prescribing patterns across England from First Databank has highlighted a wide variance in monitoring tests being undertaken.
The company is calling for GP practices to standardise routine drug therapeutic monitoring, after new data revealed a significant variance in compliance across key safety indicators both for high risk prescriptions and routinely prescribed drugs.
First Databank provides its OptimiseRx solution, a prescribing decision support tool to over 4,000 GP practices, prompting users to monitor patients if evidence of routine drug monitoring safety indicators is not found in the patient record.
Dr Simon Hendricks, Product Innovation Manager at FDB, said “Our new analysis of drug prescribing patterns across practices in England and Wales shows quite dramatic differences in evidence that essential monitoring tests are being undertaken.”
“This may be partly a reflection of the management of patients across care settings and shared care arrangements or simply a variation in how reliable systems are for practices entering on patient records when a test has been carried out. Further work, in partnership with other relevant organisations, will uncover whether the absence of routine ordering of tests for one medication correlates with an absence of processes relating to drug therapeutic monitoring and recording of results in general.”
“In highlighting to prescribers when there is no record of an essential test being carried out, within a specified timeframe, we are providing a valuable reminder that the prescriber is responsible for the ongoing safe management of patients’ long-term use of medications.”
One example the study found, for amiodarone prescriptions where its side effects are of continuing clinical concern, prescribers were alerted on more than one in five occasions to the absence of a thyroid function test being recorded.
Prompting for appropriate monitoring of liver function in the same patient group was lower, with 16% of prescriptions not having evidence of liver function tests recorded in the previous nine months.
For diabetic patients taking metformin there was an 8.5% incidence of serum creatinine tests – a monitor for potential kidney impairment – being missed or not recorded within the necessary 12 month period.
