This programme has now closed but you may find the below resources useful. Please note the information on this webpage was correct at the time of publication.
Medication errors are an important and expensive preventable cause of patient safety incidents associated with morbidity, hospitalisations and death. Errors happen for a number of reasons but main causes include ‘contraindications’ (different drugs used together), failure to take action on computer warnings, and lack of appropriate monitoring and breakdown of safety systems. PINCER helps tackle these issues.
PINCER is a proven ‘Pharmacist-led INformation technology intervention for reducing Clinically important Errors’ that was developed by the PRIMIS team, part of the School of Medicine at the University of Nottingham.
It allows GPs to review patient records and identify patients who are being prescribed medicines that are commonly and consistently associated with medication errors and therefore enables action to be taken to reduce the risk of these errors occurring. A key element to the PINCER intervention is the change management process that follows the identification of patients, where risk-cause analysis and action plans are led by a pharmacist to support lasting change to prescribing habits.
The PRIMIS team undertook a study to see what effect using PINCER had on patient safety and found that it was effective in reducing the range of clinically important and common medication errors in general practice when combined with a pharmacist to undertake the patient reviews.
The West of England AHSN, working closely with Clinical Commissioning Groups (CCGs), supported the implementation of PINCER in three CCG regions in the West of England. The West of England AHSN supported pharmacy colleagues from the Bath and North East Somerset, Gloucestershire and Bristol, South Gloucestershire and North Somerset regions through a series of Action Learning Sets (ALS) to understand the PINCER intervention and accompanying quality improvement framework.
In September 2020, PRIMIS published a National Progress report, indicating that the programme had the following impact nationally:
- 13,387 (-14.4%) fewer patients at risk of medication error (of the 1,060 GP practices providing a repeat upload of data)
- Greatest reductions for those indicators associated with GI bleed (10,559 fewer patients at risk, -25.9%)
In the West of England AHSN region, within 6 months of the programme being implemented the impact has been (based on 153 practices who uploaded two data sets):
- 1573 patients are no longer at risk.
- Change in 12.4% of patients identified to be at risk at baseline.
- 7% of the national reduction of patients who were at risk at the start of the programme.
- The West of England AHSN region, on a national basis, had the second highest number of practices completing two data uploads.
Find out more about the PINCER tool, including the evidence base, on the PINCER website.
Click here for a helpful summary of PINCER including answers to frequently asked questions.
Read about PINCER and The GP pharmacists leading a life-saving medicines safety project. (This article can be read twice per month).
Below are a selection of resources if you’re looking for something more specific:
- Practice Meeting Crib Sheet
- Dr Sarah Rodgers (University of Nottingham) Presentation June 2017
- Identifying the Need for Change Handout
- National PINCER Dataset Evidence Based Summaries
- Revised PINCER Query Library 2015 Evidence-Based Summaries
- PINCER Lancet paper
- PINCER Query Library 2013 Evidence‐Based Summaries
- The PINCER intervention Myth Buster
- ACT Academy: Root cause analysis
using five whys
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