DQIP - Data-driven Quality Improvement in Primary Care

The research program, funded by the Chief Scientist Office (The Scottish Government), developed and evaluated an intervention to improve drug therapy safety in outpatient care. The first step was to develop indicators to identify "high risk prescriptions" in a consensus process, which were then implemented in a web-based IT tool.

The tool enables GP practices to identify patients with high-risk prescriptions of antithrombotics (e.g. ASA, phenprocoumon) and/or non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or diclofenac) who have an increased risk of adverse drug reactions (gastrointestinal bleeding, acute renal failure, heart failure). In addition, the DQIP intervention included an "Educational outreach visit (EOV)", i.e. a one-hour educational event conducted by a pharmacist in GP practices, as well as financial incentives for GPs (€20 per medication analysis performed by the GP on a patient with a high-risk prescription identified by the IT tool). The intervention was evaluated in a cluster-randomized study in 34 GP practices and the results were published in the New England Journal of Medicine in 2016.

Dreischulte T, Grant A, Hapca A, Guthrie B. Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: quantitative examination of variation between practices in recruitment, implementation and effectiveness. BMJ Open. 2018 Jan 5;8(1):e017133. doi: 10.1136/bmjopen-2017-017133.

Grant A, Dreischulte T, Guthrie B. Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: case study evaluation of adoption and maintenance of a complex intervention to reduce high-risk primary care prescribing. BMJ Open. 2017 Mar 10;7(3):e015281. doi: 10.1136/bmjopen-2016-015281.

Grant A, Dreischulte T, Guthrie B. Process evaluation of the data-driven quality improvement in primary care (DQIP) trial: active and less active ingredients of a multi-component complex intervention to reduce high-risk primary care prescribing. Implement Sci. 2017 Jan 7;12(1):4. doi: 10.1186/s13012-016-0531-2.

Grant AM, Guthrie B, Dreischulte T. Developing a complex intervention to improve prescribing safety in primary care: mixed methods feasibility and optimization pilot study. BMJ Open. 2014 Jan 21;4(1):e004153. doi: 10.1136/bmjopen-2013-004153.

Grant A, Dreischulte T, Treweek S, Guthrie B. Study protocol of a mixed-methods evaluation of a cluster randomized trial to improve the safety of NSAID and antiplatelet prescribing: data-driven quality improvement in primary care. Trials. 2012 Aug 28;13:154. doi: 10.1186/1745-6215-13-154.

Dreischulte T, Grant A, Donnan P, McCowan C, Davey P, Petrie D, Treweek S, Guthrie B. A cluster randomized stepped wedge trial to evaluate the effectiveness of a multifaceted information technology-based intervention in reducing high-risk prescribing of non-steroidal anti-inflammatory drugs and antiplatelets in primary medical care: the DQIP study protocol. Implement Sci. 2012 Mar 23;7:24. doi: 10.1186/1748-5908-7-24.