022 Meds Management: OneDrug Risk

The OneDrugRisk searches are designed to identify patients who have:

1. Monitoring requirements outstanding
   
2. Hazard scenarios present
   
3. Quality issues identified

The OneDrugrisk folder forms part of 022 Meds Management

In order to understand the OneDrugRisk folder, it is helpful to look at the Drug Monitoring, Hazard scenarios, and Quality Searches folders first and work our way through these:

Drug Monitoring

This folder contains a number of searches to identify where required monitoring hasn't happened, including:

Drug	FBC	U&E	LFT	HbA1c	TFT	CRP	Lithium	ECG
Amiodarone		Yes	Yes		Yes			Yes
Aminophylline		Yes
Azathioprine	Yes	Yes	Yes			Yes
Carbimazole					Yes
Ciclosporin	Yes	Yes	Yes			Yes
Digoxin		Yes
D-Penicillamine	Yes
Dronedarone		Yes	Yes					Yes
Eplerenone		Yes
Leflunomide	Yes	Yes	Yes
Levothyroxine					Yes
Lithium		Yes	Yes	Yes	Yes		Yes
Methotrexate	Yes	Yes	Yes			Yes
Mycophenolate	Yes	Yes	Yes
Riluzole			Yes
Sulfasalazine	Yes	Yes	Yes			Yes
Tacrolimus	Yes	Yes	Yes	Yes
Valproate	Yes		Yes
Warfarin

Some of these drugs to be monitored have mirrored searches in 032 CQC Navigator or other elements of the PCIT toolset.  

The above searches can be looked at individually or all patients overdue can be identified in the searches in the OneDrugRisk (base) folder, which is detailed in a section further down in this article.

Hazard Scenarios

This folder contains a number of areas where there are hazards with prescribing. Therefore, we would recommend reviewing the patients included in these searches and reports, to identify where action is required to eliminate the hazard.

Quality Searches

These searches are more detailed quality searches.   These are not summarised or included in the base folder summaries and so need reviewing individually.

The search at the top 'Reasons NOT TO REVIEW (see description)' in this folder aims to identify patients who you would not review the prescribing for. This included end of like care and metastatic disease patients. Additional clinical rules can be added to this search which will be cross referenced against/excluded from all of the other prescribing searches within this folder.

OneDrugRisk folder

The base folder contains some summary searches:

The first two searches (OHR-000a and OHR-000b) are designed to include patients with any of the drug monitoring requirements identified.  Users can decide which of the Drug Monitoring searches their practice wishes to use and edit the search "OHR-000a) OneHighRiskDrug (monitoring due - Practice selected drugs)" to only include these particular drugs. You can do this by clicking on the rule you wish to remove (so it is highlighted blue), then select delete at the top of the page and it will remove that rule/drug from the search. Once you have removed the appropriate drugs, you can click save and close or save and run (at the top of the page)

The search "OHR-000b) OneHighRiskDrug (any drug monitoring due - complete list)" is designed to retain all Drug Monitoring patients that can be identified, so the practice can compare this with the selected list that they have chosen to use themselves.  

The search "OHR-002) OneHighRiskDrug (hazard scenarios - any)" includes all of the hazard scenario searches and will pull in all patients affected in this way.

Searches OHR-001a) and OHR-001b) combine the hazard scenarios with the practice selected monitoring drugs (OHR-000a) and the complete list of monitoring drugs (OHR-000b).  In this way practices can identify all hazard scenarios along with patients that have drug monitoring that is outstanding

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