Table 1.
Source descriptors of indicators
| Source (by age of publication, most recent first) | Indicators reviewed from source | Indicators used in round 1 of the consensus process | Source details | Relevance to prescribing safety indicators |
|---|---|---|---|---|
| PINCER trial:16 cluster randomised pharmacist intervention trial | 11 | 6 | Outcome measures of the trial used as indicators | Used to inform the 2009 RCGP indicators |
| Guthrie et al:17 Scottish general practice prevalence of inappropriate prescribing to vulnerable patients | 15 | 12 (some crossover with other sources) | New paper published since the RCGP indicator set was developed, indicators taken from consensus | All were considered related to safety but some overlapped with the 2009 RCGP indicators |
| Wessel et al:6 prevalence of prescribing and monitoring errors | 30 | 11 (some crossover with other sources) | Data from US GP patients, indicators developed by the research team | Some drug–disease combinations represented quality rather than safety |
| NORGEP:7 potentially inappropriate prescriptions for older people | 36 | 5 (all of these were also found in other sources) | Based on Norwegian consensus panel | Many drugs are not relevant to the UK or are no longer prescribed |
| STOPP/START:5 Irish prescribing indicators | 65 | 27 | Many relate to appropriateness rather than safety | Used to inform the 2009 RCGP indicators |
| Basger et al:8 Prescribing Indicators Tool for Elderly Australians | 48 | 4 (all of these were also found in other sources) | Based on the most commonly prescribed drugs to Australians aged >65 years | Many indicators reflect quality, especially secondary prevention of cardiovascular disease |
| Raebel et al:9 laboratory safety monitoring in ambulatory patients | 9 | 3 (some crossover with other sources) | Computerised tool used on US GP records | Some recommendations were considered to have too little evidence in their favour |
| Zhan et al:10 Potentially harmful drug–drug and drug–disease combinations | 56 | No formal indicators but 3 co-prescribing statements related to warfarin | Data from elderly US outpatients, indicators from consensus | Many drug–disease combinations represented quality rather than safety |
| PDRM:14 Manchester indicators on preventable drug-related morbidity | 29 | 4 | Successfully tested in English GP surgeries | Used to inform the 2009 RCGP indicators |
| Beers 2003 update:3 US indicators of prescribing safety in older people | 89 | 20 | Although updated again in 2012 these indicators are US-specific and many cover situations not felt to be of high clinical importance | Used to inform the 2009 RCGP indicators |
| ACOVE:4 Assessing Care of Vulnerable Elders | 217 | 2 | Many process measures, minority related to safety | Used to inform the 2009 RCGP indicators |
| McLeod et al:11 defining inappropriate prescribing practices for older people | 71 | 6 (all of these were also found in other sources) | Canadian consensus process dating from 1997 | Many indicators were outdated (new pharmacological evidence) |