Anthony J. Avery, M.D., from Queen's Medical Centre in Nottingham, U.K., and colleagues randomly assigned 72 general practices, comprising 480,942 at-risk patients, to computerized feedback or a pharmacist-led information technology intervention (PINCER), consisting of computerized feedback plus educational outreach and dedicated support.
At six months, the researchers found that patients in the PINCER group with a history of peptic ulcer were significantly less likely to have been prescribed a non-selective non-steroidal anti-inflammatory drug without also being prescribed a proton-pump inhibitor (odds ratio [OR], 0.58). Patients with a history of asthma in the PINCER group were also significantly less likely to be prescribed a β-blocker (OR, 0.73). Patients 75 years or older in the PINCER group were significantly less likely to be prescribed long-term angiotensin converting enzyme inhibitors or loop diuretics without appropriate monitoring (OR, 0.51). PINCER was found to be cost-effective, at £75 per error avoided at six months.
"The PINCER intervention is an effective method for reducing a range of medication errors in general practices with computerized clinical records," Avery and colleagues conclude.
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