Monitory

Audit-based education to implement NICE Do-Not-Do recommendations in people with cardiometabolic multimorbidity (MONITORY): a cluster randomised trial

Aims

To investigate whether an audit-based education (ABE) tool to implement five NICE ‘Do-Not-Do’ recommendations in people with cardiometabolic multimorbidity can improve adherence to these recommendations compared with standard care alone.

Deliverables

Report to funder and submission to scientific journal.

Expected Impact

The project will demonstrate whether ABE can be used as a method to facilitate adherence to clinical guidelines in primary care.

Project outline

The National Institute for Health and Care Excellence (NICE) has identified >800 clinical interventions that should be discontinued or not used routinely in the NHS. Implementation of ‘Do-Not-Do’ recommendations could reduce inappropriate prescribing and lessen hospital admissions due to adverse events. However, the recommendations tend to be overlooked by clinicians due to competing commitments and limited time. Audit-based education (ABE) could be used to implement ‘Do-Not-Do’ recommendations to simplify the process for clinicians.

How does this research try to address the problem?

We are performing a 12-month intervention study to explore whether an ABE package for GPs can improve adherence to 5 “Do-Not-Do” recommendations for medication prescribing compared to standard care alone. The recommendations will be specific to people with multiple cardiometabolic conditions such as cardiovascular disease, hypertension, chronic kidney disease and diabetes. The study populations comprises of GP surgeries in England that are members of the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network.

How we are planning to implement the research outputs

The findings of these analyses will be compiled into a report and submitted to the funder, and manuscript for publication in a primary care/diabetes/cardiovascular disease journal.

How were the patient and public involved?

We are conducting semi-structured interviews with GP staff to ascertain their knowledge about the ‘Do-Not-Do’ recommendations. These include GPs, pharmacists, nurse prescribers and physician’s associates. We have also spoken with patients from a regional PPI group to get input on aspects of the study design.