Preventing prescribing errors in south London with PINCER

Preventing prescribing errors in south London with PINCER

PINCER is the Pharmacist-led Information technology iNtervention for the reduction of Clinically important ERrors in medicines management.

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Overview

PINCER searches GP clinical systems using computerised prescribing safety indicators to identify patients that have been prescribed multiple medicines that may not always work together or require specific monitoring. The software works to flag these patients, so that the pharmacist can review and improve systems to avoid future errors, reducing the patients’ risk of complications and to make prescribing even safer in primary care. It is managed by a team (PRIMIS) based at the University of Nottingham.

The PINCER Intervention comprises three core elements:

  1. Searching GP computer systems to identify patients at risk of potentially hazardous prescribing using a set of prescribing safety indicators referred to as the PINCER Indicators and set out in the Operation Manual.
  2. Pharmacists, specifically trained to deliver the intervention, providing an educational outreach intervention where they meet with GPs and other practice staff to: (i) discuss the search results and highlight the importance of the hazardous prescribing identified using brief educational materials; (ii) agree an action plan for reviewing patients identified as high risk and improving prescribing and medication monitoring systems using root cause analysis (RCA) to minimise future risk.
  3. Pharmacists (and pharmacy technicians) working with, and supporting, general practice staff to implement the agreed action plan.

PINCER is now being rolled out nationally by all 15 Academic Health Science Networks (AHSNs). The Health Innovation Network (HIN) is supporting the roll out of training and software installation in GP practices in south London.

PINCER was originally trialled in the East Midlands, with evidence published in the Lancet estimating that the software was able to reduce prescribing errors by up to 50 per cent, potentially avoiding safety incidents, illness, hospitalisations and even deaths that can occur as a result of prescription errors.

Since April 2019, the HIN has:

  • Engaged 309 practices in south London, 215 of whom have upload data on ChartOnline (a portal managed by the University of Nottingham).
  • 110+ pharmacists trained (70 South East London/ 40 South West London).
  • Over two million records have been searched, with almost 11,000 at risk patients identified.

The HIN will be offering support to PRIMIS with the national rollout of PINCER until March 2021. If you are a pharmacist or pharmacy technician working in a GP practice and would like to participate in PINCER training, please follow these instructions.

Further information

Find out more about the PINCER story.

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Key achievements

  • Engaged 309 practices in south London, 215 of whom have upload data on ChartOnline (a portal managed by the University of Nottingham).
  • 110+ pharmacists trained (70 South East London/ 40 South West London).
  • Over two million records have been searched, with almost 11,000 at risk patients identified.