PINCER which stands for (Pharmacist-led INformation technology intervention for reducing Clinically important ERrors in medication management) was a project that involved running searching using a clinical system to identify when patients are at risk of medication related harm from commonly prescribed medication.

EMAHSN worked with the PRIMS team at the University of Nottingham to support further uptake of the programme across the East Midlands and nationally via the AHSN Network.

Solutions / actions taken  

PINCER was a proven Pharmacist-led IT-based intervention to reduce clinically important medication errors in primary care. PINCER involved searching GP clinical systems using computerised prescribing safety indicators to identify patients at risk from their medication, and then acted to correct the issues and improve systems with support from pharmacists specifically trained in the intervention. These specially trained pharmacists supported practices to review patients at risk of harm but also undertook a systems review, to implement changes and provide education to improve prescribing safety.

Some of the benefits of PINCER included:

• Evidenced-based intervention to improve prescribing safety (randomised control trial published in the Lancet)
• Proven to work at scale (shown by a Health Foundation scaling up improvement study)
• Allowed efficient identification of high risk patients
• Pharmacist-led and ensured an assessment of prescribing systems and processes to improve long-term prescribing safety
• Pharmacist/pharmacy technician training provided on national clinical indicators and systems review
• Data uploads contribute to the national dataset and enabled comparison to other GP practices and areas.

Impacts and outcomes from the project 

Some of the impacts and outcomes from the project included:

• Screened more than 2.9 million patient records
• Identified 21,617 cases of potentially hazardous prescribingEMAHSN has facilitated the training of more than 250 pharmacy staff across the East Midlands109practices in the East Midlands have uploaded data more than once and this showed an absolute reduction in the number of at-risk patients by 552 (September 2020)National PINCER progress report shows a reduction in at-risk patients identified in at least one prescribing safety indicator (-14.4%), with the greatest reduction seen for those indicators associated with GI bleed (-25.9%).

Registering for PINCER and accessing training for East Midlands pharmacists and technicians

Over the last few years, we have supported the rollout of PINCER in the East Midlands. Registration and training are now coordinated by the PRIMIS team. For more information on registering please click here.

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