Pharmacist-Led Digital Intervention Reduces Hazardous Prescribing, Improves Patient Safety

The study authors found marked improvements in rates of hazardous prescribing over the 12-month study period and the success of the intervention was sustained at the end.

New research has found that a pharmacist-led digital intervention can improve patient safety when prescribing medication in general practice. According to a press release, the intervention reduced rates of hazardous prescribing by more than 40%, 12 months after it was introduced.

Prescribing and medication safety are among the biggest causes of patient health incidents, according to the study authors, who noted that the third World Health Organization Global Patient Safety Challenge is focused on medication without harm. The Safety Medication Dashboard (SMASH) intervention, developed by researchers at the National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre (NIHR GM PSTRC), aims to address these issues.

For the intervention, pharmacists working in general practice used SMASH to identify patients who are exposed to potentially hazardous prescribing. For example, the press release said that patients with a history of internal bleeding may be prescribed medications such as aspirin, which could increase the risk of further bleeds without prescribing other protective medications. SMASH identifies this issue and warns health care professionals, who can then decide on next steps.

According to the press release, the intervention is unique because it updates every evening, providing nearly real-time feedback to prescribers.

“It is designed to improve patient safety in general practice by reducing potential problems made when prescribing medication and inadequate blood-test monitoring,” said Darren Ashcroft, MSc, PhD, FRPharmS, research lead for the Medication Safety theme at the GM PSTRC, in a press release. “It brings together people and data to reduce these common medication safety problems that all too often can cause serious harm.”

The intervention was introduced to 43 general practitioner offices in Salford, England, where the study authors found marked improvements in rates of hazardous prescribing over the 12-month study period. At the end of the year, the success of the intervention was sustained. Based on these findings, the investigators are now working on scaling up the SMASH intervention to benefit the whole Greater Manchester region.

“SMASH capitalizes on the unique digital infrastructure that already existed in Salford and will soon be available for 2.8 million people in Greater Manchester,” said Niels Peek, MSc, PhD, research lead for the Safety Informatics theme at the GM PSTRC, in a press release. “This will create an integrated health system that continuously learns and improves the quality of its services.”


Pharmacist-led digital intervention reduces hazardous prescribing in general practice [news release]. EurekAlert; October 14, 2020. Accessed January 26, 2021.