Enabling local and national decision-makers to use economic evaluation to support decisions around implementing medication safety initiatives

Development work question We will build a medicines safety intervention dashboard ("MedSID") to help local/regional/national decision-makers to explore how using medicines safety interventions could reduce medication errors in their area. MedSID will allow them to work out how many hospitalisations, deaths, bed-days, costs could be avoided, according to their local priorities. MedSID will support future research including evaluating the use of MedSID. Background This project follows on from our programme grant (Avoiding patient harm through the application of prescribing safety indicators in English general practices (PRoTeCT:RP-PG-1214-20012)). We showed that PINCER (Pharmacist-led information technology intervention for medication errors) helps general practices to reduce eleven important prescribing errors. We built models to estimate patient harm and NHS costs caused by these errors. Now we want to optimise uptake of effective medication safety initiatives like PINCER to make healthcare safer for patients. These initiatives cost money, and commissioners want more than assurances of reduced errors. Aim: to build a flexible and agile open-source tool ("MedSID") to quantify the impact of PINCER on healthcare costs and patient outcomes, to influence implementation, and support research in medication safety initiatives. Objectives: Develop open-source decision-models using R-code supported by open-access repositories, and an interface (MedSID) to show results and effect of changing decision-model inputs in real time to decision-makers; Optimise MedSID to be able to inform national and regional decision-making; Work with national and local systems to develop a plan for integration (Workpackage 2) Develop a plan for future research that supports addition of recently added and future medication safety indicators, MedSID evaluation and other proposed medication safety initiatives. Development work plan (18 months from 1st November 2024) Workpackage 1: Months 1-12: Write the computer programmes "behind" MedSID, based on our 11 models. These models need to be re-written in the R programme. Months 10-15: Combine new R models with R-Shiny to create a user-friendly interactive dashboard. Workpackage 2 (months 1-18): Co-design MedSID with patients, clinicians, researchers and policy-makers to optimise how it can inform national and regional decision-making, and future evaluation, through stakeholder and dissemination meetings. Patient, user, carer and public involvement Our PPI strategy comprises the following: Project team patient members will contribute to design and analysis, and co-write outputs. They will run PPI training for the project team. Patient member of Project Steering Group Patient and Carer Steering Group will ensure the project is including patients , carers and the public s views. Anticipated impact and dissemination We aim to provide MedSID as a tool to help decision-makers make healthcare safer for patients, and support future medicines safety research. We will: present our findings to stakeholders at dissemination meetings, demonstrate the resources developed, and enlist support for broader dissemination; partner with our Patient Safety Research Collaboration to target patient, professional and policy audiences, using Facebook, Instagram and X accounts, plus newsletters. submit at least one open-access paper to an internationally recognised journal, present findings at scientific conferences, and make MedSID freely available on an open-source platform.