Webb Liz, Skingle Jum
Cardiff and Vale UHB.
Arch Dis Child. 2016 Sep;101(9):e2. doi: 10.1136/archdischild-2016-311535.50.
COPPS is a computerised outpatient prescription printing system for WP10 prescriptions. It aims to improve the quality and safety of service, as patients will be provided with a legible, complete prescription to take to a community pharmacy of their choice. Patients requiring specialist medicines will have their medicines dispensed more promptly by the hospital pharmacy or medicines home care provider. The software ensures prescriptions contain all the required information to allow safe dispensing, reducing frequency of delays. Hospital pharmacy staff have more time to explain their medicines to patients, promoting shared decision making and improved adherence leading to better health outcomes and reduced waste and harm; provide information at the time of prescribing to increase adherence to agreed care pathways and prescribing practice. It facilitates attribution of prescribing, improves governance and is more easily audited and reported; capture the costs of medicines dispensed for out-patients which will be measured using information from the hospital pharmacy computer system and CASPA.The aim of this audit was to evaluate the effect the introduction of COPPS has had on compliance with the UHB formulary, local melatonin pathway and its impact on expenditure for melatonin within the community child health clinic. The pathway states that the starting dose is 2 mg Circadin® tablet or liquid melatonin 1 mg/1 ml if necessary for individual patients.
Community Child Health prescribing data shows their highest expenditure is on melatonin. This was therefore chosen to test the impact of COPPS for a pilot study.Six months prescribing data (September 14-March 15) was obtained from COPPS. This was compared to data obtained for WP10's from hospital forms analysis for the same months the previous year (September 13-March 14) RESULTS: A 55% reduction was seen in the prescribing of non-formulary melatonin and a reduction in expenditure on melatonin by 18% or £16,000. The estimated annual reduction is £23,000.There was also a significant increase in adherence to the agreed medication pathway for melatonin.
COPPS provides information for establishment of a robust and expediated audit of medication costs and pathway compliance as shown by the melatonin results. It encourages prescribers to pick medicines from the UHB formulary and provides information that can be used to assess compliance to agreed pathways. In addition pharmacies are provided with accurate legible prescriptions and the patient receives printed copy of the prescription for the GP. A similar approach will now be used to assess the data for Attention Deficit Hyperactivity Disorder (ADHD). COPPS has recently been rolled out to another UHB community child health clinic and the local special schools and further outpatient clinics will follow. A patient satisfaction survey in the outpatient clinics will be developed and audited.
COPPS是一种用于WP10处方的计算机化门诊处方打印系统。其目的是提高服务质量和安全性，因为患者将获得一份清晰、完整的处方，可带到他们选择的社区药房。需要专科药物的患者将由医院药房或家庭药物护理提供者更迅速地配药。该软件确保处方包含所有必要信息以实现安全配药，减少延误频率。医院药房工作人员有更多时间向患者解释药物，促进共同决策并提高依从性，从而带来更好的健康结果，减少浪费和危害；在开处方时提供信息以提高对商定护理途径和处方实践的依从性。它便于处方归因，改善治理，更易于审核和报告；记录门诊配药的药物成本，这将使用医院药房计算机系统和CASPA的信息进行衡量。本次审核的目的是评估引入COPPS对遵守UHB处方集、当地褪黑素治疗途径的影响及其对社区儿童健康诊所内褪黑素支出的影响。该途径规定起始剂量为2毫克Circadin®片剂，或根据个体患者需要为1毫克/1毫升的液体褪黑素。
社区儿童健康处方数据显示，他们最高的支出是在褪黑素上。因此选择对其进行测试，以评估COPPS的影响进行一项试点研究。从COPPS获取了六个月的处方数据（2014年9月至2015年3月）。将其与上一年同一月份（2013年9月至2014年3月）从医院表格分析中获得的WP10数据进行比较。结果：非处方集褪黑素的处方量减少了55%，褪黑素支出减少了18%或16,000英镑。估计年度减少额为23,000英镑。褪黑素商定用药途径的依从性也有显著提高。
如褪黑素结果所示，COPPS为建立强大且快速的药物成本和途径合规性审核提供信息。它鼓励开处方者从UHB处方集中选择药物，并提供可用于评估对商定途径依从性的信息。此外，药房可获得准确清晰的处方，患者会收到给全科医生的处方打印件。现在将采用类似方法评估注意力缺陷多动障碍（ADHD）的数据。COPPS最近已推广到另一家UHB社区儿童健康诊所以及当地特殊学校，更多门诊诊所也将陆续采用。将在门诊诊所开展并审核患者满意度调查。
