Optional Handy Protocols – Medicines Safety

Optional Handy Protocols – Medicines Safety

Optional Handy Protocols – Medicines Safety

Looking for Base Handy Protocols? Click here

Introduction

These Handy Protocols are designed to support safe prescribing in EMIS Web. They work in the background to provide timely prompts and alerts for prescribers, ensuring risks are reduced and best practice is followed.

This section covers all Optional Handy Protocols for:

  • Clinical Area: Medicines Management

  • Resource Category: Medicines Safety

  • User Type: Prescriber

The Optional set can be enabled selectively by practices/PCNs/ICBs depending on local policy, medicines optimisation priorities, or patient population needs.

Themes Explained

Optional Handy Protocols have been grouped into themes to make them easier to navigate:

  • Prescribing safety information – provides safety prompts linked to renal function, dosing thresholds, or patient advice.

  • Automated prescribing tools – automatically generates safe prescribing options when certain conditions are coded.

  • Antimicrobial stewardship – supports appropriate antibiotic prescribing and avoidance of low-value or unsafe regimens.

  • Contraindications to prescribing – highlights when prescribing is unsafe due to monitoring gaps or patient factors.

  • Pregnancy & teratogenicity – flags medicines with teratogenic risk or requiring pregnancy prevention programmes.

  • Lipid & cardiovascular medicines – supports safe, evidence-based prescribing of statins, lipid agents, and cardiovascular drugs.

  • NSAIDs, antiplatelets & anticoagulation – ensures safe use of high-risk combinations that increase bleeding or GI risk.

  • Respiratory risks – supports safer prescribing in asthma and COPD, avoiding harmful combinations.

  • Mental health prescribing – highlights risks associated with antipsychotics in older adults.

Optional Handy Protocols – Overview by Theme

Theme
Protocol
Resource Type
Function
Identifier
Prescribing safety informationeGFR Value Alert When prescribingProtocol AlertShows eGFR information when medication prescribedHP013
Sick day rulesProtocolPrompts patient advice on drug cessation when unwellHP026
Automated prescribing toolsHelicobacter Eradication automaticProtocolPrompts eradication regimen when codedHP050
MRSA decolonisationProtocolSuggests regimen for MRSA treatmentHP056
Antimicrobial stewardshipThree Day Antibiotic UTIProtocolPrompts 3-day course in uncomplicated UTIHP141
Nitrofurantoin vs TrimethoprimProtocolSuggests correct antibiotic for UTIHP142
Topical treatment of fungal nail infectionsProtocol AlertFlags topical antifungal useHP154
Ceph/Quin/Co-amox alertProtocolWarns of antimicrobial riskHP205
Contraindications to prescribingEsmya Ulipristal New Rx PreventerProtocolPrevents unsafe new prescribingHP070
Esmya Ulipristal LFT ZapProtocolFlags need for LFT monitoringHP071
Esmya Ulipristal LFT absent panelProtocolWarns if LFTs not doneHP072
Esmya Ulipristal Signs of liver diseaseProtocolWarns if signs of liver disease presentHP073
Pregnancy & teratogenicityValproate Prescribing PPPProtocolEnforces pregnancy prevention programmeHP086
Topiramate & PregnancyProtocolWarns of teratogenic riskHP087
Lipid & cardiovascular medicinesSimvastatin to Atorvastatin SwitchProtocol AlertPrompts switch for guideline complianceHP091
Low Intensity StatinsProtocol AlertWarns if statin intensity is below guidanceHP147
Other lipid-modifying drugsProtocol AlertWarns for specialist-only lipid agentsHP149
High Cost Cardiovascular DrugsProtocol AlertFlags high-cost/non-formulary useHP150
Simvastatin & Amlodipine/Diltiazem RiskProtocolWarns of interaction riskHP196
NSAIDs, antiplatelets & anticoagulationPINCER01 NSAIDs PrescribingProtocol AlertIdentifies unsafe NSAID useHP110
PINCER02 NSAIDs AlertProtocol AlertWarns of NSAID risksHP111
PINCER03 Antiplatelet PrescribingProtocol AlertIdentifies unsafe antiplatelet useHP112
PINCER04 Antiplatelet AlertProtocol AlertWarns of bleeding riskHP113
PINCER05 Anticoag + NSAID PrescribingProtocol AlertIdentifies unsafe combinationHP114
PINCER06 NSAID + Anticoag PrescribingProtocol AlertIdentifies unsafe combinationHP115
PINCER07 NSAID + Anticoag AlertProtocol AlertWarns of bleeding riskHP116
PINCER08 Anticoag + Antiplatelet No PPI PrescribingProtocol AlertIdentifies patients missing PPIHP117
PINCER09 Anticoag + Antiplatelet No PPI AlertProtocol AlertWarns of GI risk without PPIHP118
Antiplatelets & STIAProtocol AlertPrompts correct antiplatelet useHP145
RespiratoryPINCER10 NonSel BB + Asthma PrescribingProtocol AlertIdentifies prescribing of non-selective BBHP119
PINCER11 NonSel BB + Asthma AlertProtocol AlertWarns of risk in asthma patientsHP120
PINCER12 LABA no ICS PrescribingProtocol AlertIdentifies unsafe LABA useHP121
PINCER13 LABA no ICS AlertProtocol AlertWarns if LABA prescribed without ICSHP122
Mental healthPINCER14 Dem 65+ Antipsych PrescribingProtocol AlertIdentifies long-term prescribing in older adultsHP123
PINCER15 Dem 65+ Antipsych AlertProtocol AlertFlags inappropriate prescribing in older adultsHP124

Hints and Tips

  • Optional protocols: discuss as a team which are most relevant to your patient population.

  • Review regularly: medicines safety is a fast-moving area; check periodically for updates or new Handy Protocol releases.

  • Cross-linking: when reviewing Clinical Areas (e.g., Asthma, Cardiovascular), check the Handy Protocols list for relevant alerts.

  • Training: ensure prescribers understand what each alert means and how to respond.


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