Use of Primary Care Data in Research and Pharmacovigilance: Eight Scenarios Where Prescription Data are Absent

Okoli, Grace; Myles, Puja; Murray‐Thomas, Tarita; Shepherd, Hilary; Wong, Ian C. K.; Edwards, Duncan

doi:10.1007/s40264-021-01093-9

Cited by 9 publications

(11 citation statements)

References 26 publications

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“…First, with regards data sources, the incompleteness of individual primary care prescribing data sources is a known limitation 47 48. Our findings regarding challenges to link available data sources are consistent with recent reporting on the Dutch health information system in general17 and ultimately, common to many European routine healthcare information systems 48–50.…”

Section: Discussionsupporting

confidence: 81%

“…47 48 Our findings regarding challenges to link available data sources are consistent with recent reporting on the Dutch health information system in general 17 and ultimately, common to many European routine healthcare information systems. [48][49][50] Importantly, while often justified as a legal constraint, regulations like GDPR in fact leave much room for national legislation. 51 Recent Dutch initiatives like the 'Electronic Data Exchange in Health Care Bill' 52 and national quality and information standards for the exchange of medication data 53 54 are important steps being taken for more integrated data at the point of care.…”

Section: Discussionmentioning

confidence: 99%

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Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis

et al. 2022

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ObjectivesTo explore available data sources, secondary uses and key considerations for optimising the actionability of primary care prescribing data to improve quality of care in the Dutch context.DesignAn exploratory qualitative study was undertaken based on semi-structured interviews. We anchored our investigation around three tracer prescription types: antibiotics; benzodiazepines and opioids. Descriptive and explanatory themes were derived from interview data using thematic analysis.SettingStakeholders were sampled from across the micro (clinical), meso (organisational) and macro (policy) contexts of the Dutch primary care system.ParticipantsThe study involved 28 informants representing general practitioners (GPs), community pharmacists, regional chronic care networks (care groups), academia and research institutes, insurers, professional associations, electronic health record (EHR) vendors and national authorities.ResultsIn the Netherlands, three main sources of data for improving prescribing in primary care are in use: clinical data in the EHRs of GP practices; pharmacy data in community pharmacy databases and claims data of insurers. While the secondary use of pharmacy and claims data is well-established across levels, the use of these data together with EHR data is limited. Important differences in the types of prescribing information needed by micro-meso-macro context are found, though the extent to which current indicators address these varies by prescription type. Five main themes were identified as areas for optimising data use: (1) measuring what matters, (2) increasing data linkages, (3) improving data quality, (4) facilitating data sharing and (5) optimising fit for use analysis.ConclusionsTo make primary care prescribing data useful for improving quality, consolidated patient-specific data on the indication for a prescription and dispensed medicine, over time, is needed. In the Netherlands, the selection of indicators requires further prioritisation to better signal the appropriateness and long-term use of prescription drugs. Prioritising data linkages is critical towards more actionable use.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis

et al. 2022

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“…This limitation of primary care prescribing data (i.e. the exclusion of medicines from specialist clinics, pharmacies and private doctors) has been documented previously [ 25 ]. However, in the Western Cape, HIV care in pregnancy is transferred to the antenatal facility and ART is indicated in all pregnant WLHIV [ 18 ] so the poorer representation of ART in the clinician record may reflect non-reporting and/or poor clinical record-keeping [ 26 , 27 ], a limitation that should be addressed by on-going training and supervision of clinical staff.…”

Section: Discussionmentioning

confidence: 99%

Determining antenatal medicine exposures in South African women: a comparison of three methods of ascertainment

Hoven

Allen

Cois

et al. 2022

BMC Pregnancy Childbirth

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Background In the absence of clinical trials, data on the safety of medicine exposures in pregnancy are dependent on observational studies conducted after the agent has been licensed for use. This requires an accurate history of antenatal medicine use to determine potential risks. Medication use is commonly determined by self-report, clinician records, and electronic pharmacy data; different data sources may be more informative for different types of medication and resources may differ by setting. We compared three methods to determine antenatal medicine use (self-report, clinician records and electronic pharmacy dispensing records [EDR]) in women attending antenatal care at a primary care facility in Cape Town, South Africa in a setting with high HIV prevalence. Methods Structured, interview-administered questionnaires recorded self-reported medicine use. Data were collected from clinician records and EDR on the same participants. We determined agreement between these data sources using Cohen’s kappa and, lacking a gold standard, used Latent Class Analysis to estimate sensitivity, specificity and positive predictive value (PPV) for each data source. Results Between 55% and 89% of 967 women had any medicine use documented depending on the data source (median number of medicines/participant = 5 [IQR 3–6]). Agreement between the datasets was poor regardless of class except for antiretroviral therapy (ART; kappa 0.6–0.71). Overall, agreement was better between the EDR and self-report than with either dataset and the clinician records. Sensitivity and PPV were higher for self-report and the EDR and were similar for the two. Self-report was the best source for over-the-counter, traditional and complementary medicines; clinician records for vaccines and supplements; and EDR for chronic medicines. Conclusions Medicine use in pregnancy was common and no single data source included all the medicines used. ART was the most consistently reported across all three datasets but otherwise agreement between them was poor and dependent on class. Using a single data collection method will under-estimate medicine use in pregnancy and the choice of data source should be guided by the class of the agents being investigated.

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“…En este mismo sentido, un estudio en Bolivia de evaluación de las BPP, se encontró que ninguna de las recetas evaluadas cumplió con todos los parámetros establecidos en la ley, además, se observó que los errores más frecuentes se relacionaron con la omisión de información de la forma farmacéutica, del tiempo de duración del tratamiento, uso de abreviaturas, entre otros 21 , estos resultados son comparables con nuestro estudio. Por medio de la receta se logra tener información valiosa de la prescripción, pero es importante considerar que los datos contenidos pueden estar expuestos a mala interpretación, debido a las recetas incompletas o no legibles 22,23 .…”

Section: Discussionunclassified

Valoración de buenas prácticas de prescripción en recetas médicas en Honduras

Copland

Cáceres

2022

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Las Buenas Prácticas de Prescripción, consideran varios conceptos y procedimientos para su cumplimiento, entre ellos, aspectos técnicos para la verificación de información que debe contener una receta, contribuyendo así, con el uso racional de los medicamentos. Este estudio tuvo como objetivo evaluar recetas médicas para verificar el cumplimiento de los requisitos de acuerdo con Guías para las Buenas Prácticas de Prescripción. La información se recolectó a través de un instrumento semiestructurado, cotejando cada una de las recetas. El análisis y validación de la información se realizó en dos momentos, por investigadores diferentes. La muestra de 497 recetas evidenció que el 46.28% omitían parcialmente información del médico, 36.82% la información del paciente y el 37.02% se consideró letra no legible, el porcentaje más alto de cumplimiento lo representó la dosis con un 90.54%. Los resultados de este estudio demuestran que un alto porcentaje de las recetas evaluadas incumplen en los aspectos de Buenas Prácticas de Prescripción. En conclusión, es necesaria la intervención y creación de un reglamento en Honduras, para mejorar el proceso de prescripción, estandarizar el formato e información que se plasma en la receta, así como educar al personal de salud responsable de prescribir y dispensar. Palabras claves: medicamento; recetario; calidad.

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Use of Primary Care Data in Research and Pharmacovigilance: Eight Scenarios Where Prescription Data are Absent

Cited by 9 publications

References 26 publications

Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis

Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis

Determining antenatal medicine exposures in South African women: a comparison of three methods of ascertainment

Valoración de buenas prácticas de prescripción en recetas médicas en Honduras

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