Azwa Shamsuddin
Strategies supporting sustainable prescribing safety improvement interventions in English primary care: A qualitative study
Shamsuddin, Azwa; Jeffries, Mark; Sheikh, Aziz; Laing, Libby; Salema, Nde-Eshimuni; Avery, Anthony; Chuter, Antony; Waring, Justin; Keers, Richard
Authors
Mark Jeffries
Aziz Sheikh
Libby Laing
Nde-Eshimuni Salema
Anthony Avery
Antony Chuter
Justin Waring
Richard Keers
Abstract
Background: While the use of prescribing safety indicators (PSI) can reduce potentially hazardous prescribing, there is a need to identify actionable strategies for the successful implementation and sustainable delivery of PSI-based interventions in general practice.
Aim: To identify strategies for the successful implementation and sustainable use of PSI-based interventions in routine primary care.
Design & setting: Qualitative study in primary care settings across England.
Method: Anchoring on a complex pharmacist-led
IT-based intervention (PINCER) and clinical decision support (CDS) for prescribing and medicines management, a qualitative study was conducted using sequential, multiple methods. The methods comprised documentary analysis, semi-structured interviews, and online workshops to identify challenges and possible solutions to the longer-term sustainability of PINCER and CDS. Thematic analysis was used for the documentary analysis and stakeholder workshops, while template analysis was used for the semi-structured interviews.
Findings across the three methods were synthesised using the RE-AIM (reach, efficacy, adoption, implementation, and maintenance) framework.
Results: Forty-eight documents were analysed, and 27 interviews and two workshops involving 20 participants were undertaken. Five main issues were identified, which aligned with the adoption and maintenance dimensions of RE-AIM: fitting into current context (adoption); engaging hearts and minds (maintenance); building resilience (maintenance); achieving engagement with secondary care
(maintenance); and emphasising complementarity (maintenance).
Conclusion: Extending ownership of prescribing safety beyond primary care-based pharmacists, and achieving greater alignment between general practice and hospital prescribing safety initiatives, is
fundamental to achieve sustained impact of PSI-based interventions in primary care.
Citation
Shamsuddin, A., Jeffries, M., Sheikh, A., Laing, L., Salema, N.-E., Avery, A., Chuter, A., Waring, J., & Keers, R. (2021). Strategies supporting sustainable prescribing safety improvement interventions in English primary care: A qualitative study. BJGP Open, 5(5), https://doi.org/10.3399/BJGPO.2021.0109
Journal Article Type | Article |
---|---|
Acceptance Date | Jun 25, 2021 |
Online Publication Date | Oct 26, 2021 |
Publication Date | 2021-10 |
Deposit Date | Apr 22, 2022 |
Publicly Available Date | Apr 22, 2022 |
Print ISSN | 2398-3795 |
Publisher | Royal College of General Practitioners |
Peer Reviewed | Peer Reviewed |
Volume | 5 |
Issue | 5 |
DOI | https://doi.org/10.3399/BJGPO.2021.0109 |
Keywords | General practice; Implementation; Patient safety; Prescribing safety; Primary health care; Sustainability |
Public URL | https://hull-repository.worktribe.com/output/3866479 |
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Publisher Licence URL
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Copyright Statement
Copyright © 2021, The Authors. This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)
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