Practice Partner Research Network medication safety indicator descriptions, practice adherence medians and benchmarks
| Indicator description | Eligible patients (n) | Median (range) (%) | Benchmark (%) | No of practices achieving benchmark |
| Avoiding potentially inappropriate treatment | ||||
| Avoidance of antibiotics within 3 days of URI26 | Pts with a dx of common cold, pharyngitis, or acute bronchitis in the past year* (n=7100) | 46 (13–92) | 82 | 2 |
| Avoidance of inappropriate medications in the elderly† 27 | Pts ≥65 years (n=9347) | 99 (94–100) | 99 | 12 |
| Avoidance of rarely appropriate medications in the elderly‡ 27 | Pts ≥65 years (n=9347) | 96 (86–100) | 98 | 4 |
| Avoiding potentially inappropriate dosing | ||||
Allopurinol in renal dysfunction28
| Pts with CrCl <60 ml/min and active rx (n=117) | 71 (25–100) | 100 | 4 |
Short-acting benzodiazepine dosing in the elderly29
| Pts ≥ 65 years and active rx (n=890) | 95 (84–100) | 99 | 8 |
| Digoxin ≤0.125 mg in the elderly with CHF29 | Pts ≥65 yrs with a dx of CHF and active rx (n=77) | 90 (0–100) | 100 | 6 |
H-2 blockers in renal dysfunction30
| Pts with CrCl <50 ml/min and active rx (n=116) | 50 (0–100) | 77 | 3 |
| Avoiding potential drug–drug interactions31 | ||||
| Avoidance of macrolide antibiotics (excluding azithromycin) and digoxin22 | Pts on either drug (n=493) | 100 (100–100) | 100 | 20 |
| Avoidance of tetracycline and digoxin | Pts on either drug (n=415) | 100 (100–100) | 100 | 19§ |
| Avoidance of itraconazole and statin | Pts on either drug (n=11 935) | 100 (100–100) | 100 | 20 |
| Avoidance of lithium and thiazide | Pts on either drug (n=7824) | 100 (99–100) | 100 | 20 |
| Avoidance of methotrexate and trimethoprim22 | Pts on either drug (n=510) | 100 (100–100) | 100 | 20 |
| Avoidance of (ACEI or ARB) with K-sparing diuretic in high-risk patients9 | Pts ≥65 years or CrCl <50 ml/min on either drug (n=4776) | 95 (87–100) | 99 | 4 |
| Avoidance of sulfonylurea and sulfamethoxazole in the elderly9 | Pts ≥65 years on either drug (n=760) | 100 (99–100) | 99 | 19 |
| Avoiding potential drug–disease interactions | ||||
| Avoidance of anticholinergics in dementia18 29 | Pts with dx of dementia (n=429) | 86 (0–100) | 90 | 6 |
| Avoidance of bupropion in epilepsy22 | Pts with dx of epilepsy (n=367) | 100 (75–100) | 100 | 16 |
| Avoidance of metformin in renal impairment32 | Pts with most recent SCr ≥1.5 mg/dl (men) and SCr ≥ 1.4 mg/dl (women) (n=1336) | 100 (93–100) | 99 | 14 |
| Avoidance of metoclopramide in Parkinson's disease22 24 | Pts with dx of Parkinson's disease (n=101) | 100 (50–100) | 100 | 13 |
| Avoidance of NSAID or Cox 2 Inhibitor in CHF, HTN or renal dysfunction18 | Pts with dx of CHF, HTN or CrCl ≤20 ml/min (n=18 438) | 87 (75–95) | 93 | 2 |
| Avoidance of NSAID in peptic ulcer disease1 | Pts with dx of peptic ulcer disease (n=287) | 100 (71–100) | 100 | 10 |
| Avoidance of thiazolidinedione in CHF33 | Pts with dx of CHF (n=716) | 96 (57–100) | 97 | 8 |
| Monitoring/preventing potential adverse drug events23 | ||||
| Serum creatinine monitoring18 ¶ | Pts with active rx for ACEI or ARB, digoxin, diuretic** metformin, NSAID or COX2 inhibitor, or (ACEI or ARB) with K-sparing diuretic (n=19 190) | 80 (54–96) | 92 | 2 |
| Potassium monitoring¶ | Pts with active rx for ACEI or ARB, digoxin, diuretic or (ACEI or ARB) with K-sparing diuretic (n=14 938) | 84 (54–97) | 93 | 2 |
| Potassium: most recent ≥ 3.5 meq/l34 | Pts with active rx for any thiazide and potassium measure (n=6218) | 96 (92–100) | 99 | 3 |
| Annual haemoglobin and platelet count1 35 | Pts with active rx for anti-platelet (excluding aspirin) or oral anticoagulant (n=1962) | 74 (23–94) | 89 | 3 |
| Annual glucose36 37 | Pts with active rx for antipsychotic (n=733) | 78 (50–100) | 93 | 4 |
| Annual weight36 37 | Pts with active rx for antipsychotic (n=733) | 96 (70–100) | 97 | 10 |
| INR in the past 30 days35 | Pts with active rx for warfarin (n=841) | 54 (0–92) | 85 | 2 |
| Most recent INR ≤535 38 | Pts with active rx for warfarin and INR within 30 days (n=530) | 100 (92–100) | 100 | 16 |
| Folic acid use in pts on methotrexate39 | Pts with active rx for methotrexate (n=100) | 60 (0–100) | 88 | 2 |
ACEI, ACE inhibitor; ARB, angiotensin receptor blocker; CHF, congestive heart failure; COX, cyclo-oxygenase; dx, diagnosis; INR, international normalised ratio; NSAID, non-steroidal anti-inflammatory drug; Pts, patients; rx, prescription; URI, upper respiratory infection.
↵* Patients with concomitant diagnosis of otitis media, pneumonia or sinusitis were excluded.
↵† Barbiturates, flurazepam, meprobamate, chlorpropamide, meperidine, pentazocine, trimethobenzamide, belladonna alkaloids, propantheline, dicyclomine, hyoscyamine.
↵‡ Chlordiazepoxide, diazepam, propoxyphene, carisoprodol, chlorzoxazone, cyclobenzaprine, metaxalone, methocarbamol.
↵§ One practice had no eligible patients.
↵¶ Annual for all classes listed except in the past 6 months for high-risk patients ≥65 years of age or CrCl <50 ml/min on (ACEI or ARB) and K-sparing combination.
↵** Thiazide, loop, K-sparing or spironolactone.