Safer Prescribing for Frailty

A quality improvement approach resulted in a 6% reduction in average number of prescription items for people with frailty. 


Connected Yorkshire CHC contributed to a series of learning workshops led by the Yorkshire and Humber AHSN Quality Improvement Academy and the Medicines Optimisation Programme. In this collaborative project funded by the Health Foundation, the electronic frailty index was used to identify patients taking a large number of medicines and begin to provide evidenced-based tools to support deprescribing.


Working in collaboration with clinical pharmacists to support deprescribing, the electronic frailty index (eFI) was used to identify eligible patients within primary care. GPs and primary care professionals attended the workshops and implemented the quality improvement (QI) approach in their Practices based on the Institute for Healthcare Improvement (IHI) QI model. The improvement measure was a reduction in the number of prescribed items for identifiable clinical reasons.


This resulted in case-based medication and polypharmacy reviews being implemented by GPs across Practices in Yorkshire and Humber resulting in a 6% reduction in average number of prescriptions per person. With eFI being accessible to 90% of England through electronic patient record systems, an expansion through the medicines optimisation programmes nationally could delivery savings and service improvement at scale.


The eFI is automatically populated with routine primary care electronic health record (EHR) data and has been validated using data from 900,000 UK primary care patients. It has been implemented into the SystmOne EHR, which is used by 100% of practices in Bradford and around 70% of practices in Yorkshire & Humber.


The eFI has now also been implemented into the EMIS Web EHR as part of the Yorkshire & Humber AHSN Improvement Academy Healthy Ageing Collaborative, enabling availability to the large majority of GPs across Yorkshire & Humber, and around 90% of GPs across the UK.

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