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

Medicines Update Primary Care April 2016

Open Source GP Practice Prescribing Data in Scotland


On 12 April 2016, the ISD Prescribing Team at NHS National Services Scotland published a significant volume of its data, in line with Scottish Government Policy regarding transparency of information held by public bodies. The new publication of monthly prescribing activity data includes two aspects - a summary statistics dashboard and a data extract (.csv).
Summary Statistics Dashboard
The Tableau based dashboard reports on cost and volume of prescriptions dispensed and paid in the community. Data is presented as a total at NHS Board level and does not drill down to individual drugs.
 Prescribing Data Extract File
The data extract is presented as downloadable text (.csv) file. It contains details of items dispensed in the community at prescribing location code level for General Practice data and aggregated by NHS Board for other prescriber location types. Items are described at BNF item description level.
The following supporting documents can be downloaded from the iSD website:  http://www.isdscotland.org/Health-Topics/Prescribing-and-Medicines/
• Summary overview of the data to be published
• Glossary of terms including details of the data fields in the monthly file
• Privacy risk assessment of the data to be published

 
Prescribing Management Group – Primary Care

Prescribing Indicators 2016-17

 


Background
Prescribing indicators use prescription data to provide a measure of prescribing activity in specified therapeutic areas and a comparison across the GP practices in NHS GGC. These act as a focus for the work of prescribing support team members within a practice supporting improvements in safe, quality and cost effective prescribing.

Development
Prescribing indicators covering key therapeutic areas have been developed nationally by the Therapeutics Branch of the Scottish Government’s Quality Unit.  These indicators cover proton pump inhibitors, respiratory inhalers, hypnotics/anxiolytics, analgesics, antibiotics, antidiabetic drugs, non-steroidal anti-inflammatory drugs and antimicrobial wound management products.

Prescribing measures use prescription data that is linked to CHI to directly address patient safety issues, such as the prescribing of drug combinations that are known to increase the risk of adverse drug reactions.  These complement the indicators.

NHS GGC prescribing indicators for 2016-17 also have additional indicators and measures that support work on local prescribing issues that are not sufficiently covered by the national therapeutic indicators and additional prescribing measures.  These are detailed here:

The local prescribing indicators:

The local prescribing measures:

-          Antimuscarinics (overall prescribing rate)

-          Antidepressants (overall prescribing rate)

-          Blood glucose test strips (% preferred list)

-          Respiratory inhalers (% preferred list and > 14  ICS (incl combinations) per annum)

-          Antidepressants (long-term prescribing)

-          Blood glucose test strips (cost per 50 strips)

 

2016-17 GGC Prescribing Indicators and Measures (March 2016)

 

Indicators

Measures

Gastrointestinal

Proton Pump Inhibitors: DDDs per 1,000 weighted LS per day

 

Cardiovascular

 

Oral anticoagulant: number of patients prescribed an antiplatelet also prescribed an oral anticoagulant but without gastroprotection as percentage of all patients prescribed an oral anticoagulant (EFIPPS)

Respiratory

Preferred list Inhalers: Preferred list respiratory inhalers as a percentage of all respiratory inhalers (items)

High Strength Corticosteroid Inhalers: High Strength Corticosteroid Inhalers  as a percentage of all corticosteroid inhalers (items)

Corticosteroid Inhalers (including combination inhalers): number of patients prescribed more than 14 ICS inhalers in a year as a percentage of all patients prescribed ICS inhalers

Under 12 years prescribed high strength corticosteroid inhalers as a percentage of all children prescribed inhaled corticosteroids

Mucolytics:  DDDs per 100 weighted LS per day

Short Acting Beta-Agonist (SABA) Inhalers: number of patients prescribed more than 12 SABA inhalers in a year as a percentage of all patients prescribed SABAs

CNS - psychotropic

Hypnotics and Anxiolytics: DDDs per 1,000 weighted LS per day

Hypnotics and Anxiolytics diazepam 2mg tablets as a percentage of all diazepam tablets (items)

Antipsychotic: number of patients aged ≥75 years prescribed antipsychotics (EFIPPS) as percentage of all people aged ≥75 years

Antidepressants: DDDs per 1,000 weighted LS per day

Antidepressants: number of patients prescribed the same antidepressant long-term (>2 years) as a % of all patients prescribed antidepressants (excluding amitriptyline)

CNS - analgesic 

Opioid analgesics: Strong opioids(including tramadol products) DDDs per 1,000 weighted LS per day

Opioid analgesics: number of patients prescribed strong opioids long term (>2 years) as a percentage of all patients prescribed strong opioids

Opioid analgesics: Step 2 Opioids (other than strong opioids) DDDs per 1,000 weighted LS per day

Opioid analgesics: number of patients prescribed average daily dose of opioid equivalent to ≥ 120mg per day of morphine as a percentage of all patients prescribed step 2 and strong opioids

 

Opioid analgesics: Morphine as a percentage of all morphine, oxycodone, fentanyl, tapentadol, and hydromorphine prescribed (DDDs)

Gabapentanoids: pregabalin and gabapentin DDDs per 1,000 weighted LS per day

Gabapentanoids: number of patients prescribed > 1 DDD per day of gabapentanoid as a percentage of all patients prescribed a gabapentanoids (6 months)

Antimuscarinics/

Anticholinergics

Antimuscarinics: Drugs for urinary frequency, enuresis, and incontinence(BNF 4.7.2 excluding duloxetine and mirabegron) DDDs per 1,000 weighted LS per day

Anticholinergics: number of patients aged ≥75 dispensed > 10 items of strong or very strong anticholinergics (mARS 3&2) in 12 months as a percentage of people aged ≥75 years

Antibiotics

Antibiotics: Total antibiotic script items per 1,000 LS per day

Antibiotics: number of patients >4 antibiotics per 1,000 LS per 100 days

Antibiotics: 4C antibiotics script items per 1,000 LS per 100 days

Antibiotics: number of adult women prescribed a 3-day course of acute UTI antibiotics as a percentage of all adult women prescribed acute UTI antibiotics

Drugs for Diabetes

Antidiabetic Drugs: Metformin as percentage of all anti-diabetic drugs (DDDs)

SMBG: average cost per 50 blood glucose test strips (quantity)

SMBG: number of patients prescribed insulin not prescribed blood glucose test strips as a percentage of patients prescribed insulin

SMBG: Preferred list blood glucose test strips as a percentage of all blood glucose test strips (items)

SMBG: number of patients prescribed blood glucose test strips who are not prescribed treatments for diabetes (insulins and/or antidiabetic drugs) or are only prescribed metformin as a percentage of all patients prescribed blood glucose test strips

Musculoskeletal

NSAIDs including Cox-2 inhibitors: DDDs per 1,000 weighted LS per day

NSAID prescribing to patients aged  ≥65 years prescribed an ACE inhibitor/angiotensin receptor blocker and a diuretic (EFIPPS) as a percentage of people aged ≥65 years

NSAID prescribing to patients aged ≥75 years without gastroprotection (EFIPPS) as a percentage of people aged ≥75 years

NSAIDs including Cox-2 inhibitors: Ibuprofen and naproxen as a percentage of all NSAIDs (DDDs)

NSAID prescribing to patients aged ≥65 years prescribed an antiplatelet without gastroprotection (EFIPPS) as a percentage of people aged ≥65 years

NSAID prescription to patients prescribed an oral anticoagulant without gastroprotection (EFIPPS) as a percentage of patients prescribed an oral anticoagulant

Wound Management

Antimicrobial Wound Products: Antimicrobial wound products as percentage of total wound products (items)

 

New Medicines

 

Black triangle meds as a percentage of all meds from BNF chapters 1-7 & 9-13 (items)

LS – List Size

 

EFIPPS - Effective Feedback to Improve Primary care Prescribing Safety

Tx – Treated

28/7/16 two indicators were amended.
Respiratory: High dose corticosteroids inhalers to include Fostair
CNS Analgesics- Strong opioids to include tramadol products