Technology could help GPs resist hospital pressure to prescribe specialist drugs

GP IT systems should be developed to improve specialist drug prescribing and help GPs resist the push to prescribe more treatments that should be issued in secondary care.

Improvements to computerised clinical decision support systems (CDSSs) could support GPs to push back against inappropriate hospital requests to prescribe specialist drugs that should be provided in secondary care, research published in the British Journal of General Practice (BJGP) suggests.

The authors suggest that improving GP CDSSs could form a ‘potential solution’ to resolve the problems and risks associated with prescribing of specialist drugs in primary care.

It comes as the number of specialist drugs issued by GPs rose from 1.3m in 2006/07 to 1.7m in 2014/15.

The researchers warned that the current process is ‘prone to error’, with a significant number of these errors having ‘a high probability of occurrence’.

GP prescribing

They interviewed 12 key respondents to investigate the use of CDSSs followed by an observational study looking at nine GPs performing case study scenarios as they prescribed specialist drugs from hospital requests.

Errors of omission due to a lack of information were the most common errors, which could lead to GPs prescribing drugs that should only be prescribed in hospitals or prescribing specialist drugs without reference to a shared protocol.

They said: ‘A CDSS supporting GPs during the process of prescribing specialist drugs is needed. This could, first, support the decision making of whether or not to undertake prescribing, and, second, provide drug-specific parameters linked to shared care protocols, which could reduce the errors identified and increase patient safety.

‘In the current study it was identified that the lack of specific functionality in GP clinical systems, including CDSSs, adversely affected the GPs’ ability to resolve problems associated with prescribing of specialist drugs.’

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