Table 2.
Indicator rates for PINCER hazardous prescribing indicators: Q1 2020-21 percentages and cumulative results between 1 September 2019 and 1 September 2021
| Indicator | Q1 2020 mean percentage | Q1 2021 mean percentage | Cumulative counts | ||
| Numerator/denominator (%) |
Ratio of hazardous prescribing events to unique patients having an event | Practices with ≥1 hazardous prescribing events (% of total practices) | |||
| Gastrointestinal bleeding | — | — | 551 844/10 881 675 (5.07) | 5.53 | 6335 (99.50) |
| Age ≥65 years and NSAID | 1.11 | 0.75 | 334 487/9 207 007 (3.63) | 4.54 | 6304 (99.01) |
| PU and NSAID | 1.32 | 1.07 | 32 089/678 218 (4.73) | 3.83 | 5801 (91.11) |
| PU and antiplatelet | 4.24 | 3.85 | 41 414/678 218 (6.11) | 10.90 | 5943 (93.34) |
| Warfarin/DOAC and NSAID | 1.39 | 1.18 | 84 101/1 915 117 (4.39) | 4.57 | 6193 (97.27) |
| Warfarin/DOAC and antiplatelet | 2.26 | 1.67 | 52 575/1 249 865 (4.21) | 5.86 | 6068 (95.30) |
| Aspirin and other antiplatelet | 1.67 | 1.20 | 36 927/1 470 315 (2.51) | 7.15 | 5777 (90.73) |
| Cautioned medications | — | — | 228 587/7 594 687 (3.01) | 9.43 | 6321 (99.28) |
| HF and NSAID | 1.71 | 1.43 | 31 034/735 781 (4.22) | 6.09 | 5622 (88.30) |
| Asthma and beta blocker | 1.27 | 1.29 | 185 289/6 646 586 (2.79) | 10.24 | 6307 (99.06) |
| CRF and NSAID | 1.27 | 1.12 | 14 558/476 925 (3.05) | 4.70 | 2217 (87.08) |
| Blood test monitoring | — | — | 1 102 209/3 358 954 (32.81) | 6.59 | 6329 (99.40) |
| ACEI or loop diuretic, no blood tests | 5.16 | 12.14 | 850 587/3 095 595 (27.48) | 5.89 | 6303 (98.99) |
| Methotrexate and no FBC | 18.64 | 22.73 | 164 502/238 042 (69.11) | 5.05 | 6278 (98.60) |
| Methotrexate and no LFT | 19.62 | 23.27 | 166 484/238 042 (69.94) | 5.14 | 6278 (98.60) |
| Lithium and no level recording | 31.47 | 38.44 | 40 664/45 456 (89.46) | 6.93 | 5912 (92.85) |
| Amiodarone and no TFT | 36.20 | 39.23 | 46 268/59 925 (77.21) | 6.22 | 5993 (94.13) |
ACEI=angiotensin-converting enzyme inhibitors; CRF=chronic renal failure; DOAC=direct oral anticoagulants; FBC=full blood count; HF=heart failure; LFT=liver function test; NSAID=non-steroidal anti-inflammatory drugs; PU=peptic ulceration; TFT=thyroid function test. Mean values are calculated at the practice level; higher mean values indicate increased rates of potentially hazardous prescribing across practices in the period. Rates for CRF and NSAID are calculated across 2546 OpenSAFELY-TPP practices; all other indicator rates are calculated across all 6367 practices (2546 OpenSAFELY-TPP plus 3821 OpenSAFELY-EMIS practices). Tables for OpenSAFELY-TPP and OpenSAFELY-EMIS separately are available in online supplemental tables 1 and 2.