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

Primary Care Prescribing Decision Support Tools

The NHSGGC Central Prescribing Team maintains several prescribing decision support tools for primary care such as;

A near miss highlighted the risks of prescribers accepting suggestions provided by decision support tools without taking into account the complete action suggested. A GP intended to prescribe buccal prochlorperazine and a ScriptSwitch message suggested a switch to oral tablets given the significant costs of the buccal preparation. The message noted that the dose would have to be reviewed, however the switch was accepted without the dose or the route of administration being changed. The resultant prescription was for prochlorperazine 5mg tablets, 1-2 tablets twice daily buccally. This was picked up by the community pharmacist and amended before the product reached the patient. Prochlorperazine has a high buccal absorption, and therefore, if the patient took the standard tablets buccally at the maximum prescribed dose of 20mg per day, there would be a risk of adverse effects as this is higher than the licensed buccal dose of 12mg per day.

Prescribing decision support tools are intended to help guide clinicians to the most appropriate prescribing that is in line with local policies and guidelines and suits most common circumstances. Prescribers retain the autonomy to make the best prescribing decisions for their patients and should remember to use clinical judgement at all times when prescribing.

Should you wish to provide any comment or feedback on NHSGGC Primary Care Prescribing Decision Support Tools please contact the central prescribing team on prescribing@ggc.scot.nhs.uk.

 

Published 10/09/18