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National Therapeutic Indicators – How can EMIS help?

National Therapeutic Indicators – How can EMIS help?. Dr Keith Burns, EMIS NUG Committee, Broadbay Medical Practice, Stornoway. National therapeutic indicators. THE NATIONAL THERAPEUTIC INDICATORS 2012 (in order of BNF chapter):.

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National Therapeutic Indicators – How can EMIS help?

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  1. National Therapeutic Indicators – How can EMIS help? Dr Keith Burns, EMIS NUG Committee, Broadbay Medical Practice, Stornoway

  2. National therapeutic indicators

  3. THE NATIONAL THERAPEUTIC INDICATORS 2012 (in order of BNF chapter): • Proton Pump Inhibitors: DDDs per 1,000 patients per day.Proton Pump Inhibitors: high strength PPIs as a % of all PPIs (DDDs) • Statins: Simvastatin, atorvastatin & pravastatin as a percentage of all statins (DDD) • Ezetimibe: Ezetimibe as a percentage of ezetimibe and all statins (DDDs) • Dipyridamole MR: Dipyridamole DDD per 1,000 patients per day • High Strength Inhaled Corticosteroids: High Strength Inhaled Corticosteroids as a percentage of all inhalers (items) • Hypnotics: Hypnotics and anxiolytics DDD per patients per day • Total Antibiotic Use: total items per 1,000 patients per day4C Antibiotics: proportion of ‘4C antibiotics’ (fluoroquinolones,cephalosporins, co-amoxiclav and climamycin) items per 1,000 patients per day • Quinine Use: DDDs per 1000 patients per day • Antidiabetic drugs: established oral hypoglycaemics (metformin & sulphonylureas) as percentage of all antidiabetic drugs (DDDs) • Antimicrobial Wound Products: Antimicrobial wound products as percentage of total wound products (items)

  4. Main strategies • Removal or replacement as a batch • Prompting for clinicians • Targeting in clinics • Use of Scriptswitch were available

  5. Some just education only • Total antibiotic use – remove from repeats or review long term use for UTIs? • Antidiabetic drugs • Antimicrobial wound products – possible use of warnings if nurses prescribe using EMIS

  6. Removal or replacement • Ezetemibe • Dipyridamole MR • High strength PPI • Hypnotics? – difficult • Do a search, batch print letters and then work through the EMIS numbers

  7. Prompting for clinicians • PPI • Statins • All of the previous ones in order to stop re-starting • 4C antibiotics • Use of warning messaging in EMIS

  8. Targeting in clinics / med reviews • PPI • High strength inhaled corticosteroids • Quinine • Prompts on templates and regular reminders for clinicians to review.

  9. Use of Scriptswitch • Helping with the replacement of drugs – Dipyridamole MR • Warning for all indicators

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