NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Adding hospital medicines to GP practice systems

Within General Practice, it is beneficial to ensure that a patient's medicine record includes medicines that may be prescribed and supplied outwith the GP practice, such as the acute sector, community mental health teams. Examples of drugs might include

  • Methadone
  • Clozapine
  • Antipsychotic depot injections
  • Anti-TNFs
  • DMARDs (such as methotrexate supplied by acute services)
  • HIV drugs
  • Zoledronic acid
  • Chemotherapy
  • Homecare drugs (darbopoetin, immunoglobulins)

 

The benefits of adding these medicines to the GP practice system are

  • Increased prescriber safety: prescription record is complete allowing clinical decision support to flag drug interactions etc. Prescribers can form a more complete assessment when making prescribing decisions
  • Increased patient safety: Emergency Care Summary (ECS) is more complete
  • Improved medicines reconciliation at the interface due to more accurate ECS

 

Updates to the EMIS GP system for adding “outside” medicines, now make it impossible to print a prescription for medicines recorded in this way. This has significantly reduced the associated risks with recording these medicines in the practice system. The updated NHSGGC guidance can be found here and includes screenshots of the computer systems and how prescriptions will look when printed.

 

Please note that “outside” medicines continue to appear on the patient’s repeat medicine slip however they are now clearly segregated and there is no corresponding order tick box. Due to the sensitive nature of some “outside” medicines, eg HIV medicines, it would be appropriate to discuss with the patient that these medicines will appear on the repeat slip for their agreement.

 

There is no recommended list of non-practice drugs that should be added and no contractual requirement for GPs to maintain the complete patient medication record. However, with the increasing use of the ECS and the increasing number of medicines supplied outwith primary care which may interact with medicines that GPs commonly prescribe, eg methotrexate supplied by acute interacting with trimethoprim, practices are encouraged to record these medicines ifollowing this guidance to improve patient and prescriber safety.

 

 

Published 4th May 2017