Authors (including presenting author) :
Choy P S Ignatius (1), Chen X R Catherine (1), Li Y C (1), Ko S H (1)
Affiliation :
(1) Department of Family Medicine and Primary Healthcare, Kowloon Central Cluster
Introduction :
The aging population and chronic disease pandemic have introduced significant challenges for the General Out-Patient Clinics (GOPCs) of the Hospital Authority (HA). Specifically, multi-morbidity and polypharmacy have become pressing issues. To enhance primary and secondary care interfaces and ensure continuity of care, many new and special drugs have been added to the HA GOPC Drug List. Additionally, medication safety is crucial for patient safety and quality care, necessitating the consistent updating of knowledge among frontline doctors to minimize risks and incidents. Therefore, the Drug Formulary (DF) Subcommittee of the Department of Family Medicine and Primary Health Care (FM&PHC) has implemented a comprehensive improvement strategy aimed at ensuring the safe and smart prescription of drugs and auditing the safety and quality usage of these drugs in the Kowloon Central Cluster (KCC) FM & PHC.
Objectives :
1) To ensure safe and smart prescription of drugs in HA GOPC DF; (2) To audit the safety and quality use of these drug in KCC FM & PHC.
Methodology :
1. Staff Engagement and Education: From January 2012 to December 2024, the subcommittee issued "Drug Use Update" content thrice annually to educate staff on safe and smart drug use. Various communication channels like departmental websites, emails, and regular lunch meetings were used to disseminate important information about new drugs. The information was evidence based. There were also inputs from pharmacists regarding important precautions on drug use retrieving from Prescription Intervention and Reporting System (PIRS).
2. Quality Assurance through Regular Audits: To reduce medication incidents (MIs), regular prescription audits were conducted to ensure correct patient identification, verification of drug items, and avoidance of therapeutic duplications. DF Subcommittee members conducted bi-annual audits for special drugs, reviewing up to 20 randomly selected cases for adherence to HADF indications and departmental recommendations.
Result & Outcome :
Result
Since 2012, 36 versions of “Drug Use Update” have been issued, providing comprehensive information on drug dosages, adverse effects, precautions, contraindications, and costs. High-frequency clinical topics and cost-effective drug use were readily available on the departmental web. The bi-annual audits of special drugs achieved 100% compliance, with the exception of adherence to SGLT2 inhibitors, which was at 95% in 2024. Prescription audits for all doctors, particularly new staff, consistently met standards. Notably, prescription-related MIs significantly decreased from 20 annually in 2021 to 4 in 2024, marking a 80% reduction.
Conclusion
Medication safety is vital for maintaining quality patient care. The dual approach of involving staff through education and engagement, supplemented by audits and compliance checks, has proven effective in reducing prescription-related MIs and enhancing the overall quality of care.
