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Indicators for preventable drug related morbidity: application in primary care

¹ School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK
² Division of General Practice, University of Nottingham, Nottingham, UK

Correspondence to:
Dr C J Morris
The Drug Usage and Pharmacy Practice Group, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester M13 9PL, UK; caroline.j.morris{at}man.ac.uk Aim: To apply in practice a series of validated indicators for preventable drug related morbidity (PDRM).

Design: A pilot study to identify retrospectively potential PDRM events over a 2 year 3 month time frame using the MIQUEST computer software program.

Subjects and setting: The electronic patient record of all patients aged 18 years and over in nine English general practices.

Outcome measures: The number of potential PDRM events identified, as defined by the indicators.

Results: Five hundred and seven potential PDRM events were identified from 49 658 electronic patient records, giving an overall incidence of 1.0%. A small number of the indicators (n = 4) accounted for approximately 60% of the events, while for many indicators few events were identified. The most common events related to the use of non-steroidal anti-inflammatory drugs in patients with congestive heart failure or hypertension, lack of monitoring in patients prescribed angiotensin converting enzyme inhibitors, and the use of hypnotic-anxiolytic agents.

Conclusions: A small number of indicators contributed to the majority of the PDRM events. Interrogation of electronic patient records in primary care using computerised queries shows potential for detecting PDRM.

Keywords: drug related morbidity; general practice; quality indicators; electronic patient records

Relevant Article

Safety from numbers: identifying drug related morbidity using electronic records in primary care

G Elwyn
Qual. Saf. Health Care 2004 13: 170-171. [Extract] [Full Text] [PDF]

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				M.F. Dallenbach, P.A. Bovier, and J. Desmeules Detecting drug interactions using personal digital assistants in an out-patient clinic QJM, November 1, 2007; 100(11): 691 - 697. [Abstract] [Full Text] [PDF]

				C J Morris, J A Cantrill, A J Avery, and R L Howard Preventing drug related morbidity: a process for facilitating changes in practice. Qual. Saf. Health Care, April 1, 2006; 15(2): 116 - 121. [Abstract] [Full Text] [PDF]

				G Elwyn Safety from numbers: identifying drug related morbidity using electronic records in primary care Qual. Saf. Health Care, June 1, 2004; 13(3): 170 - 171. [Full Text]