QMAS

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QMAS ELECTRONIC PRESCRIBINGrefining
prescribing data for better analysis

• Sean MacBride-Stewart
• Primary Care Pharmacist
• Edinburgh CHP

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Content

• Prescribing Data
• QMAS Prescribing Analysis
• Electronic Prescribing

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Prescribing Data
Rx Form Type Drug Dictionary Code or Drug
name Dose Form Strength Quantity Prescriber
Code Dispenser Code Date (month)
Cost Manufacturer BNF Derived measures
Practice or pharmacy details e.g.
name address Demographics Status
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Prescribing Data

• PROS
• universal
• accurate
• spend and activity
• hierarchies
• population denominators
• history

• CONS
• delayed
• patient detail missing
• prescribing detail missing
• only community pharmacy claimed prescriptions

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QMAS Prescribing Analysis

• Quality Outcomes Framework
• 19 clinical areas
• 80 indicators worth 65.5 of the points
• 23 indicators directly or indirectly related to
  prescribing.

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QMAS Prescribing Analysis

• Direct
• e.g. CHD 10 the percentage of patients with
  coronary heart disease who are currently treated
  with a beta blocker (unless a contraindication or
  side-effects are recorded)
• Indirect
• e.g. CHD 8 the percentage of patients with
  coronary heart disease whose last measured total
  cholesterol (measured in the previous 15 months)
  is 5 mmol/l or less

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QMAS Prescribing Analysis

• QMAS provides a link to the GP Payment System to
  enable quality payments to be made
• practices can assess their achievement
• calculation of national disease prevalence

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QMAS Prescribing Analysis

• comparative data analysis from national QOF
  summaries
• no patient identifiable data
• improved analysis of prescriber behaviour

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QMAS Prescribing Analysis

• Practice-level Analysis
• GPASS reporting database for QMAS
• Spreadsheet reporting using Microsoft Query in
  Excel or Microsoft Access
• Allows for prescribing audits that highly
  automated
• Increased access to relevant data
• e.g. patient details, dose instructions

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QMAS Prescribing Analysis

• Practice-level Analysis
• Example
• Identifying patients prescribed atorvastatin
  10mg suitable for switching to simvastatin 40mg.
  
• Excludes patients with prior exposure to
  simvastatin or co-prescribing of drugs that
  interact with simvastatin.

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Electronic Prescribing

• facilitates payment of dispensed prescriptions
• reduces processing time
• improves data capture
• patient idenitifier
• drug details
• undispensed treatments

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Electronic Prescribing

• Individual patient identity protected
• basic demographics will substantially improve
  prescribing analysis
• pharmacovigilance of drugs for certain
  populations e.g. high dose steroid inhalers in
  children
• analysis of undispensed treatments
• improved analysis of prescribing behaviour

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Electronic Prescribing

• Patient identity allowed
• connecting with other datasets
• calculation of individual treatment costs
• calculation of illness treatment costs