The Hereford Hospital Prescribing Study: a computer evaluation of in-patient data

Abstract

This research project describes work undertaken to evaluate the usefulness of prescribing data collected from hospital in-patients for the Hereford Hospital Prescribing Study. The Study, which was in operation for seven years, linked patient and diagnostic details with prescription data for storage on computer. Using the collected data selected topics relating to prescribing patterns, adverse drug reactions and pharmacy practice were studied. The work involved analysis of the computer data to determine drug usage patterns or to identify individual patients receiving a particular drug with subsequent retrospective follow-up of their medical records. The data provided objective information about the physicians' choice of drugs and enabled trends to be related to the availability of new drugs, theperception of adverse drug reactions and the publication ofthe new British National Formulary. For the study of adversedrug reactions the data enabled a population who had received the drug to be identified, allowing retrospective testing of hypotheses. Further insight into adverse reactions associated with sulphasalazine, cimetidine and the non-steroidal anti-inflammatory agents was gained. The linkage of prescription data with patient and diagnostic data partly filled the need for management information relating to pharmacy practice. It was possible to predict the scope of an extended level of service and thus derive some measure of the workload and required staffing levels. On the basis of the experience gained in the operation of the Hereford Hospital Prescribing Study recommendations are made to facilitate the wider use of computer systems in hospital pharmacy. The value of linking prescribing data with clinical data is acknowledged and it is suggested that data be collected as a by-product of an operational procedure.The importance of considering computer systems in the future development of hospital pharmacy is stressed.