Evaluation of the prescribing decision support system Synonyms in primary care: a mixed-method study

Lindsay Robertson, Mairi-Anne McLean, Colette Sardar, Graeme Bryson, Amanj Kurdi

Research output: Contribution to conferenceAbstract

Abstract

Background
Primary care prescribers must cope with an increasing number and complexity of considerations. To assist prescribers, prescribing decision support systems (DSS) have been developed. The Drug Synonyms function (“Synonyms”) is a DSS inherent in the electronic medical record system EMIS, which has been further developed by the NHSGGC Central Prescribing Team to promote safe and cost-effective prescribing. By entering a disease short code (e.g. AST for asthma), prescribers are presented with appropriate prescribing choices based on local/national guidelines and NHSGGC formulary recommendations for the identified condition. Synonyms is therefore an innovative method of ensuring consistent clinical and cost-efficient prescribing. As the functionality of Synonyms does not enable usage data to be collected, there is no current knowledge regarding the uptake or effect of Synonyms. A quantitative and qualitative analysis of Synonyms uptake and usage was undertaken to determine the impact Synonyms has on primary care prescribing; this will inform the continued maintenance and/or future development of this prescribing DSS.

Aim
To determine the uptake of Synonyms and explore prescribers’ perceptions of its usefulness.

Design and setting
An exploratory sequential mixed-method observational study using quantitative questionnaires, followed by semi-structured interviews with primary care prescribers across NHSGGC.

Method
An electronic questionnaire (Questionnaire 1) accessible across 218 GP practices ascertained the uptake of Synonyms. Questionnaire 2 and interviews established its usefulness. Interviews were audio-recorded, transcribed verbatim and analysed thematically.

Results
Questionnaire 1 was completed by 201 prescribers from 43.1% of GP practices surveyed: 186 (92.5%) prescribers were aware of Synonyms, of whom 163 (87.6%) had used it and 155 (83.3%) continue to use it. Questionnaire 2 was completed by 104 prescribers: 90 (86.5%) indicated that Synonyms informs or influences their choice of drug prescribed; 94 (90.4%) reported that Synonyms changed their prescribing choice towards medication on NHSGGC formulary and 104 (100%) reported that they trust Synonyms. Six interviews generated suggestions for improvements, mainly extending the disease short code list and making Synonyms more easily identifiable.

Conclusion
Most respondents were aware of and continued to use Synonyms. Respondents perceived Synonyms to influence prescribing choices towards NHSGGC formulary medicines and improve adherence to local prescribing guidelines. This suggests that Synonyms is instrumental in standardising the quality of prescribing care within NHSGGC. Potentially, the NHSGGC Synonyms function could be utilised by other health boards with supportive clinical systems; such collaboration could standardise the appropriateness and effectiveness of primary care prescribing throughout the NHS in Scotland.

Conference

ConferenceNHS Scotland Event 2019
CountryUnited Kingdom
CityGlasgow
Period30/05/1931/05/19
Internet address

Fingerprint

Primary Health Care
Formularies
Interviews
Guidelines
Costs and Cost Analysis
Electronic Health Records
Quality of Health Care
Scotland
Surveys and Questionnaires
Pharmaceutical Preparations
Observational Studies
Asthma
Maintenance
Health

Keywords

  • primary care prescribers
  • prescribing decision support systems (DSS)
  • local/national guidelines
  • cost-efficient

Cite this

Robertson, L., McLean, M-A., Sardar, C., Bryson, G., & Kurdi, A. (2019). Evaluation of the prescribing decision support system Synonyms in primary care: a mixed-method study. Abstract from NHS Scotland Event 2019, Glasgow, United Kingdom.
Robertson, Lindsay ; McLean, Mairi-Anne ; Sardar, Colette ; Bryson, Graeme ; Kurdi, Amanj. / Evaluation of the prescribing decision support system Synonyms in primary care : a mixed-method study. Abstract from NHS Scotland Event 2019, Glasgow, United Kingdom.2 p.
@conference{6e4f472c99c3483bb05247019a007d08,
title = "Evaluation of the prescribing decision support system Synonyms in primary care: a mixed-method study",
abstract = "BackgroundPrimary care prescribers must cope with an increasing number and complexity of considerations. To assist prescribers, prescribing decision support systems (DSS) have been developed. The Drug Synonyms function (“Synonyms”) is a DSS inherent in the electronic medical record system EMIS, which has been further developed by the NHSGGC Central Prescribing Team to promote safe and cost-effective prescribing. By entering a disease short code (e.g. AST for asthma), prescribers are presented with appropriate prescribing choices based on local/national guidelines and NHSGGC formulary recommendations for the identified condition. Synonyms is therefore an innovative method of ensuring consistent clinical and cost-efficient prescribing. As the functionality of Synonyms does not enable usage data to be collected, there is no current knowledge regarding the uptake or effect of Synonyms. A quantitative and qualitative analysis of Synonyms uptake and usage was undertaken to determine the impact Synonyms has on primary care prescribing; this will inform the continued maintenance and/or future development of this prescribing DSS.AimTo determine the uptake of Synonyms and explore prescribers’ perceptions of its usefulness.Design and settingAn exploratory sequential mixed-method observational study using quantitative questionnaires, followed by semi-structured interviews with primary care prescribers across NHSGGC.MethodAn electronic questionnaire (Questionnaire 1) accessible across 218 GP practices ascertained the uptake of Synonyms. Questionnaire 2 and interviews established its usefulness. Interviews were audio-recorded, transcribed verbatim and analysed thematically. ResultsQuestionnaire 1 was completed by 201 prescribers from 43.1{\%} of GP practices surveyed: 186 (92.5{\%}) prescribers were aware of Synonyms, of whom 163 (87.6{\%}) had used it and 155 (83.3{\%}) continue to use it. Questionnaire 2 was completed by 104 prescribers: 90 (86.5{\%}) indicated that Synonyms informs or influences their choice of drug prescribed; 94 (90.4{\%}) reported that Synonyms changed their prescribing choice towards medication on NHSGGC formulary and 104 (100{\%}) reported that they trust Synonyms. Six interviews generated suggestions for improvements, mainly extending the disease short code list and making Synonyms more easily identifiable.ConclusionMost respondents were aware of and continued to use Synonyms. Respondents perceived Synonyms to influence prescribing choices towards NHSGGC formulary medicines and improve adherence to local prescribing guidelines. This suggests that Synonyms is instrumental in standardising the quality of prescribing care within NHSGGC. Potentially, the NHSGGC Synonyms function could be utilised by other health boards with supportive clinical systems; such collaboration could standardise the appropriateness and effectiveness of primary care prescribing throughout the NHS in Scotland.",
keywords = "primary care prescribers, prescribing decision support systems (DSS), local/national guidelines, cost-efficient",
author = "Lindsay Robertson and Mairi-Anne McLean and Colette Sardar and Graeme Bryson and Amanj Kurdi",
year = "2019",
month = "5",
day = "30",
language = "English",
note = "NHS Scotland Event 2019 ; Conference date: 30-05-2019 Through 31-05-2019",
url = "http://nhsscotlandevent.com/",

}

Robertson, L, McLean, M-A, Sardar, C, Bryson, G & Kurdi, A 2019, 'Evaluation of the prescribing decision support system Synonyms in primary care: a mixed-method study' NHS Scotland Event 2019, Glasgow, United Kingdom, 30/05/19 - 31/05/19, .

Evaluation of the prescribing decision support system Synonyms in primary care : a mixed-method study. / Robertson, Lindsay; McLean, Mairi-Anne; Sardar, Colette; Bryson, Graeme; Kurdi, Amanj.

2019. Abstract from NHS Scotland Event 2019, Glasgow, United Kingdom.

Research output: Contribution to conferenceAbstract

TY - CONF

T1 - Evaluation of the prescribing decision support system Synonyms in primary care

T2 - a mixed-method study

AU - Robertson, Lindsay

AU - McLean, Mairi-Anne

AU - Sardar, Colette

AU - Bryson, Graeme

AU - Kurdi, Amanj

PY - 2019/5/30

Y1 - 2019/5/30

N2 - BackgroundPrimary care prescribers must cope with an increasing number and complexity of considerations. To assist prescribers, prescribing decision support systems (DSS) have been developed. The Drug Synonyms function (“Synonyms”) is a DSS inherent in the electronic medical record system EMIS, which has been further developed by the NHSGGC Central Prescribing Team to promote safe and cost-effective prescribing. By entering a disease short code (e.g. AST for asthma), prescribers are presented with appropriate prescribing choices based on local/national guidelines and NHSGGC formulary recommendations for the identified condition. Synonyms is therefore an innovative method of ensuring consistent clinical and cost-efficient prescribing. As the functionality of Synonyms does not enable usage data to be collected, there is no current knowledge regarding the uptake or effect of Synonyms. A quantitative and qualitative analysis of Synonyms uptake and usage was undertaken to determine the impact Synonyms has on primary care prescribing; this will inform the continued maintenance and/or future development of this prescribing DSS.AimTo determine the uptake of Synonyms and explore prescribers’ perceptions of its usefulness.Design and settingAn exploratory sequential mixed-method observational study using quantitative questionnaires, followed by semi-structured interviews with primary care prescribers across NHSGGC.MethodAn electronic questionnaire (Questionnaire 1) accessible across 218 GP practices ascertained the uptake of Synonyms. Questionnaire 2 and interviews established its usefulness. Interviews were audio-recorded, transcribed verbatim and analysed thematically. ResultsQuestionnaire 1 was completed by 201 prescribers from 43.1% of GP practices surveyed: 186 (92.5%) prescribers were aware of Synonyms, of whom 163 (87.6%) had used it and 155 (83.3%) continue to use it. Questionnaire 2 was completed by 104 prescribers: 90 (86.5%) indicated that Synonyms informs or influences their choice of drug prescribed; 94 (90.4%) reported that Synonyms changed their prescribing choice towards medication on NHSGGC formulary and 104 (100%) reported that they trust Synonyms. Six interviews generated suggestions for improvements, mainly extending the disease short code list and making Synonyms more easily identifiable.ConclusionMost respondents were aware of and continued to use Synonyms. Respondents perceived Synonyms to influence prescribing choices towards NHSGGC formulary medicines and improve adherence to local prescribing guidelines. This suggests that Synonyms is instrumental in standardising the quality of prescribing care within NHSGGC. Potentially, the NHSGGC Synonyms function could be utilised by other health boards with supportive clinical systems; such collaboration could standardise the appropriateness and effectiveness of primary care prescribing throughout the NHS in Scotland.

AB - BackgroundPrimary care prescribers must cope with an increasing number and complexity of considerations. To assist prescribers, prescribing decision support systems (DSS) have been developed. The Drug Synonyms function (“Synonyms”) is a DSS inherent in the electronic medical record system EMIS, which has been further developed by the NHSGGC Central Prescribing Team to promote safe and cost-effective prescribing. By entering a disease short code (e.g. AST for asthma), prescribers are presented with appropriate prescribing choices based on local/national guidelines and NHSGGC formulary recommendations for the identified condition. Synonyms is therefore an innovative method of ensuring consistent clinical and cost-efficient prescribing. As the functionality of Synonyms does not enable usage data to be collected, there is no current knowledge regarding the uptake or effect of Synonyms. A quantitative and qualitative analysis of Synonyms uptake and usage was undertaken to determine the impact Synonyms has on primary care prescribing; this will inform the continued maintenance and/or future development of this prescribing DSS.AimTo determine the uptake of Synonyms and explore prescribers’ perceptions of its usefulness.Design and settingAn exploratory sequential mixed-method observational study using quantitative questionnaires, followed by semi-structured interviews with primary care prescribers across NHSGGC.MethodAn electronic questionnaire (Questionnaire 1) accessible across 218 GP practices ascertained the uptake of Synonyms. Questionnaire 2 and interviews established its usefulness. Interviews were audio-recorded, transcribed verbatim and analysed thematically. ResultsQuestionnaire 1 was completed by 201 prescribers from 43.1% of GP practices surveyed: 186 (92.5%) prescribers were aware of Synonyms, of whom 163 (87.6%) had used it and 155 (83.3%) continue to use it. Questionnaire 2 was completed by 104 prescribers: 90 (86.5%) indicated that Synonyms informs or influences their choice of drug prescribed; 94 (90.4%) reported that Synonyms changed their prescribing choice towards medication on NHSGGC formulary and 104 (100%) reported that they trust Synonyms. Six interviews generated suggestions for improvements, mainly extending the disease short code list and making Synonyms more easily identifiable.ConclusionMost respondents were aware of and continued to use Synonyms. Respondents perceived Synonyms to influence prescribing choices towards NHSGGC formulary medicines and improve adherence to local prescribing guidelines. This suggests that Synonyms is instrumental in standardising the quality of prescribing care within NHSGGC. Potentially, the NHSGGC Synonyms function could be utilised by other health boards with supportive clinical systems; such collaboration could standardise the appropriateness and effectiveness of primary care prescribing throughout the NHS in Scotland.

KW - primary care prescribers

KW - prescribing decision support systems (DSS)

KW - local/national guidelines

KW - cost-efficient

UR - https://nhsscotlandevent.com/

M3 - Abstract

ER -

Robertson L, McLean M-A, Sardar C, Bryson G, Kurdi A. Evaluation of the prescribing decision support system Synonyms in primary care: a mixed-method study. 2019. Abstract from NHS Scotland Event 2019, Glasgow, United Kingdom.