In Calderdale, we include a quality improvement (QI) project as part of our annual medicine's optimisation workplan and for the year 2022/23 we wanted to include a project that addressed both overprescribing and medication safety.
The workplan is delivered across all practices in Calderdale by NECS, our externally medicines optimisation commissioned team.
Whilst horizon scanning for project ideas, we identified that Calderdale were significantly above the England average for prescribing high dose proton pump inhibitors (PPIs) compared with all PPIs on the Open Prescribing dashboard.
Long term PPI use has been associated with an increase in a number of disorders, such as clostridium difficile infection, a higher risk of community-acquired pneumonia and increase risk of bone fractures. We agreed to include high dose PPI reviews as our QI project.
Following this QI project, good improvement can be seen in the March 2024 Open Prescribing dashboard (see chart below). This data shows that Calderdale were on the 70th percentile at the start of the project (April 2022) and now (March 2024) on the 42nd percentile for the prescribing high dose PPIs compared with all PPIs. We have received positive feedback from patients and clinicians.
