# | Description | Clinical aim |
---|---|---|
1 | Prescription of an oral NSAID without co-prescription of an ulcer-healing drug in a patient aged ≥65 years. | Prevent gastrointestinal bleeding. |
2 | Prescription of an oral NSAID without co-prescription of an ulcer-healing drug to a patient with a history of peptic ulceration. | Prevent gastrointestinal bleeding. |
3 | Prescription of an antiplatelet drug without co-prescription of an ulcer-healing drug to a patient with a history of peptic ulceration. | Prevent gastrointestinal bleeding. |
4 | Prescription of warfarin or NOAC in combination with an oral NSAID. | Prevent gastrointestinal bleeding. |
5 | Prescription of warfarin or NOAC in combination with and an antiplatelet drug without co-prescription of an ulcer-healing drug. | Prevent gastrointestinal bleeding. |
6 | Prescription of aspirin in combination with another antiplatelet drug without co-prescription of an ulcer-healing drug. | Prevent gastrointestinal bleeding. |
7 | Prescription of a non-selective beta-blocker to a patient with asthma. | Prevent acute asthma exacerbation. |
8 | Prescription of a long-acting beta-2 agonist inhaler (excluding combination products with inhaled corticosteroid) to a patient with asthma who is not also prescribed an inhaled corticosteroid. | Prevent acute asthma exacerbation. |
9 | Prescription of an oral NSAID to a patient with heart failure. | Prevent thrombotic risk. |
10 | Prescription of an oral NSAID to a patient with chronic renal failure (eGFR < 45) already prescribed an ACE inhibitor/ARB and loop diuretic | Prevent acute kidney injury. |
11 | Prescription of an oral NSAID to a patient with chronic renal failure (eGFR <45) | Prevent acute kidney injury. |
12 | Prescription of Methotrexate without both a recent full blood count and a recent liver function test. | Prevent liver damage (liver function test) and the development of neutropaenia (full blood count). |
13 | Prescription of Amiodarone without a thyroid function test. | Prevent hypo and hyperthyroidism. |
NOAC = novel anticoagulants such as apixaban, dabigatran or rivaroxaban. Antiplatelet drugs are aspirin, clopidogrel, prasugrel and ticagrelor. Peptic ulceration includes upper gastrointestinal bleeds, but does not include peptic ulcer surgery, gastritis, duodenitis or oesophageal varices. Ulcer-healing drugs include the PPIs and H2-antagonist – it does not include Misoprostol, Sucralfate or Bismuth.