How OpenPrescribing can help improve patient safety | Bennett Institute for Applied Data Science

How OpenPrescribing can help improve patient safety

When people talk about the use of medicines, they’ll often use this phrase from the BNF (or something like it):

Medicines are the most common intervention in healthcare for the prevention, treatment and/or management of many illnesses.

And by looking at the numbers, medicines use forms a large part of care in the NHS in England. In 2025-26 nearly 1.2 billion prescriptions were dispensed in England, costing £10.8bn. The NHS spends even more on drugs in secondary care.

And, although the statement above is important, the statement immediately following it is even more important for medicines optimisation.

As life expectancy increases and as the population ages, more people are living with several long-term conditions that are being managed with an increasing number of medicines. Medicines use can be complex and how patients can take their medicines safely and effectively is a challenge for the health service.

We know that:

According to a 2021 study, 45.6% of adults in the UK reported taking at least one medicine for a long term condition
According to a 2026 study, around 15% of 50 year olds in England had been dispensed five or more medications within a 3-month period, increasing to 42% by 70
Adverse Drug Reactions (ADRs) cause a significant amount of hospital admissions

With the increasing use and complexity of medicines, it’s really important to make sure that patients are kept as safe as possible. And as it’s #MedSafetyWeek (2nd-8th November 2026) we thought it was a good opportunity to explain how OpenPrescribing can help users improve medicines safety. We have over 25 measures which can be used to help make the use of medicines safer.

These measures help identify areas for improvement, across a number of medicines safety domains.

Short Acting Beta Agonists

The 2014 Royal College of Physicians report Why Asthma Still Kills states:

There is evidence of overuse of or over-reliance on SABA (reliever) inhalers. From prescribing data on 165 patients, 92 (56%) were prescribed more than six and 65 (39%) more than 12 SABA inhalers in the year before they died. Six patients (4%) had been prescribed more than 50 SABA inhalers in the previous year

Our measure on Short Acting Beta Inhalers allows users to identify where there may be outlying practice. You can read more in Dr Huw Miles’ blog post about how he used the measure to reduce prescribing of SABAs in his practice.

Dependency Forming Medicines

There is a concern that the prescribing of Dependency Forming Medicines (DFMs) may impact patient safety. In 2022 NICE stated:

These medicines can provide lasting symptom management with a favourable balance of benefits and adverse effects for many people. But like all medicines, they do not work for everyone and can have negative consequences that outweigh their benefits. Even when people are not getting clinical benefit, these medicines may sometimes continue to be prescribed for various reasons, including concerns about the risk of unpleasant withdrawal symptoms or fear of worsening of the underlying condition.

We have a number of measures on identifying outlying prescribing in DFMs, including:

Opioids

We know that the evidence regarding the effectiveness of opioids for long term pain is unclear, particularly at higher doses (more than 90mg/day of oral morphine), where the risk of dependency and harms are greater.

You can read Vanessa Sherwood’s blog post to learn about how she has worked to reduce inappropriate oral morphine prescribing in her PCN.

Gabapentinoids

There are increasing concerns about the use of gabapentinoids. These include the risk of dependency and addiction, respiratory depression, and overdose.

Anxiolytics and Hypnotics

This year the Medicines and Healthcare products Regulatory Agency (MHRA) strengthened warnings on the packaging for gabapentinoids, benzodiazepines, and z-drug, due to the risks of dependency, addiction, withdrawal, and tolerance.

Other drugs that can cause harm

It’s been over 25 years since concerns were raised about the safety of prescribing methotrexate 10mg tablets in the community. However, there is still some prescribing. You can read Ruth Dales’ blog post to learn more about how the National Medicines Safety Improvement Programme (MedSIP) used our measure on methotrexate 10mg tablets to improve methotrexate safety nationwide

We also have a number of measures that help identify possible erroneous prescribing of “look-alike, sound-alike” medicines, including sulfadiazine and zuclopenthixol acetate

The safety of medicines, along with ensuring clinical effectiveness and value, is a key pillar of medicines optimisation. As we’ve seen above, OpenPrescribing can help you find areas to improve your medicines safety, therefore reducing harm and improving patient outcomes.

Have you used OpenPrescribing to help your medicines safety work, or have an idea for a measure? If so, we’d love to know about it. Let us know your ideas, experiences, and case studies by dropping us an email.