PINCER02 NSAIDs Alert (HP111)

PINCER02 NSAIDs Alert (HP111)

PINCER02 NSAIDs Alert (HP111)

Purpose

This protocol will:
  1. help support the PINCER project, designed to help spot and prevent hazardous prescribing

What does it actually do?

The protocol performs the following functions:
  1. Checks to see if the patient is on an anticoagulant or an antiplatelet
  2. If they are and it is attempted to issue an anticoagulant or antiplatelet (the one they're not on) and they don't have a PPI prescribed, the user is warned in keeping with PINCER
This supports the co-prescribing of Lansoprazole 30mg OD or Omeprazole 20mg OD where DOAC + Antiplatelets are being used.


This supports PINCER Queries A, B, I & K

Query A
 In a patient aged 65 years or more, prescription of anora lNSAID without co-prescription of an ulcer healing drug
Query B
Prescription of an oral NSAID, without co-prescription of an ulcer healing drug, to patient with a history peptic ulceration (includes prior bleeds and oesophageal  varices)
Query I
Prescription of an oral NSAID to a patient with heart failure
Query K
Prescription of an oral NSAID to a patient with chronic renal failure with an eGFR < 45

What does it look like?

There are two alerts that may display:


which if the user hovers over shows the following:


The second is for over 65 year olds on NSAIDs without a PPI:


with information as follows if the user hovers over it:

System Dependencies:

This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording information

System Trigger

System Trigger: Load patient record
Run mode: Always run 
Enable trigger for: All staff

Fitting your practice

Training staff on the protocol and the PINCER queries is important as they may then spot situations where hazardous prescribing exists but where past coding has been unreliable; for example, if the prescribing has occurred outside of the organisation.

How to get it

Optional Handy Protocols will need to be 'activated' within your clinical system. See our support article for instructions: How to locate Optional Handy Protocols and Activate these