Skip to main content

Main menu

  • HOME
  • LATEST ARTICLES
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • RESOURCES
    • About BJGP Open
    • Editorial Board
    • Editorial Fellowships
    • Outreach
    • Research into Publication Science
    • Advertising
    • BJGP Life
    • Feedback
    • Alerts
    • Conference
    • eLetters
    • Audio abstracts
  • RACE AND RACISM IN PRIMARY CARE
  • RCGP
    • British Journal of General Practice
    • BJGP for RCGP members
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio

User menu

  • Alerts

Search

  • Advanced search
BJGP Open
  • RCGP
    • British Journal of General Practice
    • BJGP for RCGP members
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
Advertisement
BJGP Open

Advanced Search

  • HOME
  • LATEST ARTICLES
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • RESOURCES
    • About BJGP Open
    • Editorial Board
    • Editorial Fellowships
    • Outreach
    • Research into Publication Science
    • Advertising
    • BJGP Life
    • Feedback
    • Alerts
    • Conference
    • eLetters
    • Audio abstracts
  • RACE AND RACISM IN PRIMARY CARE
Research

Safer Prescribing and Care for the Elderly (SPACE): a pilot study in general practice

Katharine A Wallis, C Raina Elley, Simon Moyes and Ngaire Kerse
BJGP Open 2018; 2 (3): bjgpopen18X101594. DOI: https://doi.org/10.3399/bjgpopen18X101594
Katharine A Wallis
1 GP and Senior Lecturer, Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, , New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: k.wallis@auckland.ac.nz
C Raina Elley
2 GP and Associate Professor, Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, , New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Simon Moyes
3 Data Manager/Analyst, Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, , New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ngaire Kerse
4 GP and Head of School, Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, , New Zealand
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info
  • eLetters
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Figure 1.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 1. High-risk prescribing rates in study population (vulnerable at baseline) for each high-risk category and combined. BL = baseline.

Tables

  • Figures
  • Type of adverse drug eventVulnerable patients (at increased risk of ADE)High-risk prescribinga
    Gastrointestinal bleedPrior peptic ulcer everNSAID or aspirin without gastroprotection, in patient with prior peptic ulcer
    Aged ≥75 yearsNSAID without gastroprotection, in patient ≥75 years
    Aged ≥65 years prescribed aspirinNSAID without gastroprotection, in patient ≥65 years taking aspirin
    Clopidogrel without gastroprotection, in patient ≥65 years taking aspirin
    Prescribed oral anticoagulantNSAID without gastroprotection, in patient taking an oral anticoagulant
    Aspirin or clopidogrel without gastroprotection, in patient taking an oral anticoagulant
    Renal impairmentPrescribed both renin-angiotensin system blocker and diureticNSAID, in patient taking both renin-angiotensin system blocker and diuretic
    Chronic kidney disease (most recent eGFR <60)NSAID, in patient with chronic kidney disease (eGFR <60)
    Cardiac failureHeart failure everNSAID, in patient with history of heart failure
    • aMedicines prescribed within the previous 14 weeks. ADE = adverse drug event. eGFR = estimated glomerular filtration rate. NSAID = nonsteroidal anti-inflammatory drug. 

    • View popup
    Table 1. Characteristics of study population (patients who were vulnerable at baseline, that is at increased risk of an adverse drug event with non-steroidal anti-inflammatory drugs and/or antiplatelet medicinesa) from the two participating general practices
    General practice A
    (registered patients: n = 7944)
    General practice B
    (registered patients: n = 2500)
    Total
    Vulnerable patientsa, n (%)668 (8.6)202 (8.1)870 (8.9)
    Age, mean (SD)74.9 (11.2)73.2 (12.3)74.5 (11.4)
    Female, n (%)392 (58.7)96 (47.5)488 (56.1)
    Ethnicity, n (%):
     New Zealand European321 (48.1)157 (77.7)478 (54.9)
     Other European253 (37.9)23 (11.4)276 (31.7)
     New Zealand Maori7 (1.0)4 (2.0)11 (1.3)
     Pasifika5 (0.7)1 (0.5)6 (0.7)
     East Asian29 (4.3)6 (3.0)35 (4.0)
     Indian12 (1.8)7 (3.5)19 (2.2)
     Other41 (6.1)4 (2.0)45 (5.2)
    Number of long-term medicines, mean (SD)4.07 (1.86)1.35 (0.56)3.44 (2.01)
    • aPatients with one or more risk factor for gastrointestinal, renal, or cardiac adverse effects when prescribed NSAID and/or antiplatelet medicines. SD = standard deviation.

    • View popup
    Table 2. Rates of high-risk prescribing at baseline, and 6 and 12 months post-intervention for study population and for practice population overall
    Study populationaPractice populationb
    Outcome measureBaseline6-month
    n/N (%)
    P-value12-month
    n/N (%)
    P-valuec 6-month
    n/N (%)
    12-month
    n/N (%)
    Primary outcome: high-risk prescribing70/870 (8.0)47/807 (5.8);
    52/870 (6.0) LVCF
    0.030.0462/757 (8.2);
    74/870 (8.5) LVCF
    0.90.771/890 (8.0)101/1026 (9.8)
    Secondary outcomes
    High-risk prescribing among patients
    with any gastrointestinal risk factor
    35/649 (5.4)26/596 (4.4);
    29/649 (4.5) LVCF
    0.40.433/554 (6.0);
    42/649 (6.5) LVCF
    0.60.439/698 (5.6)52/731 (7.1)
    High-risk prescribing amongst patients
    with any renal risk factor
    41/476d (8.6)22/444 (5.0);
    25/476 (5.3) LVCF
    0.0070.00833/414 (8.0);
    38/476 (8.0) LVCF
    0.70.738/365 (10.4)61/536 (11.4)
    High-risk prescribing among patients
    with congestive heart failure
    1/27 (3.7)1/23 (4.4);
    1/27 (3.7) LVCF
    0.91.01/21 (4.8);
    1/27 (3.7) LVCF
    0.91.01/26 (3.9)1/25 (4.0)
    • aPatients vulnerable at baseline; that is at increased risk of adverse drug events (ADE) when prescribed NSAID and/or antiplatelet medicines (see Table 1). bAll practice vulnerable patients; that is includes patients who were not vulnerable at baseline but who have become so at 6 months and/or 12 months. cCompared with baseline.d32/870 (3.7%) patients were included as at-risk of ADE due to a low eGFR, where it could not be confirmed that the latest eGFR was still <60. LVCF = last value carried forward, which assumes that those lost to follow-up (left the practice or died) had the same high-risk prescribing status as baseline.

Back to top
Previous ArticleNext Article

In this issue

BJGP Open
Vol. 2, Issue 3
October 2018
  • Table of Contents
  • Index by author
Download PDF
Download PowerPoint
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending BJGP Open.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Safer Prescribing and Care for the Elderly (SPACE): a pilot study in general practice
(Your Name) has forwarded a page to you from BJGP Open
(Your Name) thought you would like to see this page from BJGP Open.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Safer Prescribing and Care for the Elderly (SPACE): a pilot study in general practice
Katharine A Wallis, C Raina Elley, Simon Moyes, Ngaire Kerse
BJGP Open 2018; 2 (3): bjgpopen18X101594. DOI: 10.3399/bjgpopen18X101594

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Safer Prescribing and Care for the Elderly (SPACE): a pilot study in general practice
Katharine A Wallis, C Raina Elley, Simon Moyes, Ngaire Kerse
BJGP Open 2018; 2 (3): bjgpopen18X101594. DOI: 10.3399/bjgpopen18X101594
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • Abstract
    • How this fits in
    • Introduction
    • Method
    • Results
    • Discussion
    • Funding
    • Ethical approval
    • Provenance
    • Acknowledgements
    • Notes
    • References
  • Figures & Data
  • Info
  • eLetters
  • PDF

Keywords

  • general practice
  • multimorbidity
  • Prescriptions
  • Polypharmacy
  • drug related side-effects and adverse reactions

More in this TOC Section

  • Evaluating the delay prior to primary care presentation in patients with lung cancer: a cohort study
  • Alternative approaches to managing respiratory tract infections: a survey of public perceptions
  • Supporting bereavement and complicated grief in primary care: a realist review
Show more Research

Related Articles

Cited By...

Advertisement

@BJGPOpen's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Latest articles
  • Authors & reviewers

RCGP

  • British Journal of General Practice
  • BJGP for RCGP members
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers
  • RCGP e-Portfolio

MY ACCOUNT

  • RCGP members' login
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP Open
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP Open: research
  • Writing for BJGP Open: practice & policy
  • BJGP Open editorial process & policies
  • BJGP Open ethical guidelines
  • Peer review for BJGP Open

CUSTOMER SERVICES

  • Advertising
  • Open access licence

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Open Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7679
Email: bjgpopen@rcgp.org.uk

BJGP Open is an editorially-independent publication of the Royal College of General Practitioners

© 2021 BJGP Open

Online ISSN: 2398-3795