Four new measures available on OpenPrescribing.net (and four have been retired)

At OpenPrescribing.net we like to create new measures to help our users find outlying behaviour in prescribing quality, safety, and cost-effectiveness. Some of the ideas come from within the team, while others come from national recommendations and from our users.

We have recently released four new measures based on national recommendations, and we’ll describe these below.

We’ve also reviewed our list of measures, and have decided to retire a few measures where they’re not as relevant as they used to be.

New Antimicrobial measures

There are two new antimicrobial measures now available on our website: courses for amoxicillin 500mg greater than 15 capsules and courses for doxycycline 100mg greater than 6 capsules/dispersible tablets.

Both of these are based on NICE guidance, which recommends a five-day course for the most common respiratory-tract infections treated by these antibiotics. Reducing the course length of antimicrobial prescribing also forms a key part of the NHS England National Medicines Optimisation Opportunities for 2023-24, with a desire to achieve 75% of amoxicillin prescriptions as a five-day course.

There is significant variation across practices, Sub-ICB Locations (SICBLs) and ICBs for both of these measures, although some ICBs are showing recent changes in prescribing behaviour. As usual in OpenPrescribing.net, “low is good”, and therefore these markers are showing the proportion of antibiotic prescriptions which are over a usual five-day course.

As it’s currently World AMR Awareness Week, now is a good time to review prescribing on these markers. We are also working on similar markers for other common antibiotics, and hope to release these shortly.

New Diabetes measures

In Spring 2023 NHS England produced commissioning recommendations on the use of blood glucose and ketone meters and strips, and lancets. We have produced two measures on the topic: Blood glucose testing strips not included in NHS England commissioning recommendations and Blood glucose testing lancets not included in NHS England commissioning recommendations.

Both of these measures show the proportion of prescriptions for test strips or lancets which are not included in the NHS England recommendations. We are currently reviewing them on a regular basis to ensure that new meters which were recommended in the guidance before being generally available are included in the measure as soon as possible.

Retired measures

We’ve also taken the opportunity to retire a few measures that are not quite as useful as they used to be. These are:

• Pregabalin capsules prescribed as Lyrica
• High-cost PPIs
• High-cost Angiotensin-Converting Enzyme (ACE) inhibitors
• Direct Oral Anticoagulants (DOACs) as proportion of all DOACs and warfarin

You can see a list of our retired measures here.

Let us know if you have any ideas for new measures or feedback

Many of our measures start with users - and we’re always very grateful for feedback. For example, we had feedback from an NHS user pointing out that we’d missed a product (although they have different BNF codes, WaveSense DUO JAZZ is the same as WaveSense JAZZ, but in two pots of 25, rather than one pot of 50), and you can see our change history here.

We spend a lot of time scoping, prototyping and testing measures before they are released openly onto the website. In some cases these ideas work, and in other cases we find that it’s either too complicated to achieve, or that the results are not what we expected. In the blog following this one we’ll describe the process we follow, with a couple of examples on what went well (and what didn’t).

If you have any questions, ideas, or to point out where we’ve gone wrong, we’d be delighted to hear from you, either by email or tagging us on X (formerly Twitter).