New research aims to make prescribing of medication safer for people in prison

Manchester-based researchers have taken an important step towards making it safer for people in prison who are prescribed medication.

The research*, published in the British Journal of Clinical Pharmacology, involved searching electronic health records to uncover how many people in prisons have been affected by a potential problem related to their prescribed medication.

The research was funded by Greater Manchester Mental Health NHS Foundation Trust (GMMH) Research Capability Funding and the National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre (NIHR GM PSTRC). The Centre is a partnership between The University of Manchester and The Northern Care Alliance NHS Foundation Trust.

Researchers worked with prison pharmacists who conducted searches of the electronic healthcare records of two large prisons to identify how often people were affected by 13 ‘Prescribing Safety Indicators’ (PSIs). For example, prescribing of antipsychotic medication without carrying out the essential physical health tests to monitor weight, blood sugar and cholesterol.

To develop the PSIs researchers looked at published studies and worked with prison healthcare staff to identify the common situations where potentially hazardous prescribing can occur.

Dr Richard Keers works with the GM PSTRC, and is a Clinical Lecturer in Pharmacy at The University of Manchester. He also co-leads the Suicide, Risk and Safety Research Unit based at GMMH where this work originated, and said: “Our research has shown that Prescribing Safety Indicators can be successfully implemented into prison electronic health records, and that they provide a significant opportunity to measure and improve medication safety for people in prisons as we have already seen in primary care.”

The results of the study revealed that more patients were affected by some PSIs than others. Understanding how the searches could be used more widely in prisons was also investigated with researchers interviewing 20 prison health care staff to explore this topic.

The staff they spoke to said that having people who can take on the leadership of the searches and working together as a team to respond to them was important.

Prof Darren Ashcroft, Director of the NIHR Greater Manchester PSTRC, said: “Our next step is to use these results to launch a new study. We are now working with a prison health care provider to test the introduction of the electronic health record searches and a way for staff to work together to respond to them across a large group of prisons nationally. This will take place over the next 18-24 months to see how effective this is at improving medication safety.”

* Implementing prescribing safety indicators in prisons: a mixed methods study

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