Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 16;21(1):e10929.
doi: 10.2196/10929.

Measuring the Impact of an Open Web-Based Prescribing Data Analysis Service on Clinical Practice: Cohort Study on NHS England Data

Alex J Walker  1 , Helen J Curtis  1 , Richard Croker  1 , Seb Bacon  1 , Ben Goldacre  1
Affiliations

Measuring the Impact of an Open Web-Based Prescribing Data Analysis Service on Clinical Practice: Cohort Study on NHS England Data

Alex J Walker et al. J Med Internet Res. .

Abstract

Background: OpenPrescribing is a freely accessible service that enables any user to view and analyze the National Health Service (NHS) primary care prescribing data at the level of individual practices. This tool is intended to improve the quality, safety, and cost-effectiveness of prescribing.

Objective: We aimed to measure the impact of OpenPrescribing being viewed on subsequent prescribing.

Methods: Having preregistered our protocol and code, we measured three different metrics of prescribing quality (mean percentile across 34 existing OpenPrescribing quality measures, available "price-per-unit" savings, and total "low-priority prescribing" spend) to see whether they changed after the viewing of Clinical Commissioning Group (CCG) and practice pages. We also measured whether practices whose data were viewed on OpenPrescribing differed in prescribing, prior to viewing, compared with those who were not. We used fixed-effects and between-effects linear panel regression to isolate change over time and differences between practices, respectively. We adjusted for the month of prescribing in the fixed-effects model to remove underlying trends in outcome measures.

Results: We found a reduction in available price-per-unit savings for both practices and CCGs after their pages were viewed. The saving was greater at practice level (-£40.42 per thousand patients per month; 95% CI -54.04 to -26.81) than at CCG level (-£14.70 per thousand patients per month; 95% CI -25.56 to -3.84). We estimate a total saving since launch of £243 thosand at practice level and £1.47 million at CCG level between the feature launch and end of follow-up (August to November 2017) among practices viewed. If the observed savings from practices viewed were extrapolated to all practices, this would generate £26.8 million in annual savings for the NHS, approximately 20% of the total possible savings from this method. The other two measures were not different after CCGs or practices were viewed. Practices that were viewed had worse prescribing quality scores overall prior to viewing.

Conclusions: We found a positive impact from the use of OpenPrescribing, specifically for the class of savings opportunities that can only be identified by using this tool. Furthermore, we show that it is possible to conduct a robust analysis of the impact of such a Web-based service on clinical practice.

Keywords: cost control; drug prescribing; patient safety; treatment efficacy.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors are, in whole or in part, funded by grants related to the OpenPrescribing project. As described in the paper, we have used open, pre-registered methods and analytic code, in order to reduce the impact of this conflict of interest as far as possible. BG has received funding from the Health Foundation, the National Institute for Health Research (NIHR) School of Primary Care Research, the NIHR Biomedical Research Centre Oxford, the West of England Academic Health Sciences Network and National Health Service England for work on United Kingdom prescribing data. BG has additionally received funding from the Laura and John Arnold Foundation, the Wellcome Trust and the World Health Organization to work on better use of data in medicine and receives personal income from speaking and writing for lay audiences on the misuse of science.

References

    1. Croker R, Walker AJ, Bacon S, Curtis HJ, French L, Goldacre B. New mechanism to identify cost savings in English NHS prescribing: minimising 'price per unit', a cross-sectional study. BMJ Open. 2018 Dec 08;8(2):e019643. doi: 10.1136/bmjopen-2017-019643. http://bmjopen.bmj.com/cgi/pmidlookup?view=long&pmid=29439078 bmjopen-2017-019643 - DOI - PMC - PubMed
    1. Walker AJ, Curtis HJ, Bacon S, Croker R, Goldacre B. Trends and variation in prescribing of low-priority treatments identified by NHS England: a cross-sectional study and interactive data tool in English primary care. J R Soc Med. 2018 Jun;111(6):203–213. doi: 10.1177/0141076818769408. http://europepmc.org/abstract/MED/29787684 - DOI - PMC - PubMed
    1. Oracle. [2018-04-11]. NHS Business Services Authority Gains Better Insight into Data, Identifies circa GBP100 Million (US$156 Million) in Potential Savings in Just Three Months https://www.oracle.com/uk/customers/nhsbsa-1-advanced-analytics.html.
    1. Optum. [2018-04-11]. ScriptSwitch http://www.optum.co.uk/how-we-help/scriptswitch.html .
    1. Prescribing Services. [2018-04-11]. Our Mission https://www.prescribingservices.org/our-mission/

Publication types

LinkOut - more resources