A Randomised Pilot Study of the REVISiT Intervention

Summary

In 2012, the General Medical Council (GMC) funded PRACtICe (PRevalence And Causes of prescrIbing errors in general practiCe) study, reported that 1 in 20 prescriptions in general practice were found to have a prescribing or monitoring error. The PRACtICe study also proposed some strategies to consider to improve prescribing safety.

Further to the PRACtICe study, in line with recommendation from the Medical Research Council (MRC) for developing complex interventions, we conducted a series of focus groups with health care professionals and members of the public to identify possible ways to improve the prescribing education provided for general practitioner (GP) trainees - a group that was identified as likely to benefit from additional education and training in prescribing safety. These focus group discussions identified a pharmacist-led review of the prescribing done by GP trainees, together with feedback, as a promising potential intervention. This intervention, named REVISiT, was piloted with ten trainees and their trainers in the East Midlands. The error rate for the trainees was recorded as 9%. Interviews with the trainees and trainers undertaken following the intervention highlighted that REVISiT was positively received. Some GPs gave examples of how their prescribing practice had changed following the intervention.

After this pilot study, we conducted another study involving interviews, focus groups and a stakeholder event with key stakeholders (practice, policy, legal and members of the public) to explore the next steps for REVISiT. Whilst some participants proposed that REVISiT be immediately implemented with minor modifications, others pointed to the need to establish the impact of the intervention more broadly (including its impact in areas other than education and training). Additionally, they highlighted the importance of establishing its effectiveness in order to support making a substantial case for future allocation of resources. Conducting a randomised controlled trial (RCT) would help establish the effectiveness of the REVISIT intervention and its impact on areas of professional practice that may impact prescribing safety. However, before we can do this, there are components of the REVISiT intervention and RCT process that we need to further explore, test and refine in order for it to be employed on a wider basis. This pilot study of the REVISiT intervention is being undertaken to do this further exploration, testing and refining.

Conditions

• Patient Safety
• Inappropriate Prescribing
• Medication Errors

Interventions

OTHER

REVISiT intervention

REVISiT is a pharmacist-led retrospective review of prescribing followed by a feedback meeting to discuss the review findings.

Sponsors & Collaborators

• University of Manchester

  collaborator OTHER

• University of Nottingham

  lead OTHER

Principal Investigators

• Richard A Knox, MBChB · University of Nottingham

• Nde-Eshimuni M Salema, PhD · University of Nottingham

• Anthony J Avery, DM · University of Nottingham

• Darren Ashcroft, PhD · University of Manchester

• Chris Armitage, PhD · University of Manchester

• Brian Bell, PhD · University of Nottingham

• Glen Swanwick · Patient and Public Involvement

• Jeanne-Anna Charly · Patient and Public Involvement

• Gill Gookey · Clinical Commissioning Group collaborators

• Mindy Bassi · Clinical Commissioning Group collaborators

• Richard Williams, BA · University of Manchester

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2020-07-30

Primary Completion

2022-08-01

Completion

2022-12-16

Countries

• United Kingdom

Study Locations