Quality Improvement project based on the latest NICE Clinical Knowledge Summary recommendation of maximum of once-daily oral Ferrous dosing for iron-deficiency anaemia. STOPP criteria states that oral doses greater than 200mg elemental iron daily have ‘no evidence of enhanced iron absorption’. (I queried the elemantal iron value with the Specialist Pharmacy Service and they said it equates to one standard tablet of oral Ferrous).
Created a population reporting search via EMIS Web (because none pre-existed) and discovered that a large proportion of our patients did not have optimised treatment, some were overprescribed ferrous preparations (based on their prescribed dose, frequency, duration and serum Haemoglobin results) and/or had not been monitored of followed-up.
Shared this with other practices within my Primary Care Network and audited across 2 practices for 6 months as a quality improvement project.
I also did a presentation on the QI project progress.Within 6 months at 1 Practice, we achieved and increase in <=1OD frequency prescribing of oral ferrous preparations from 33.9% to 91.25%; and had reduced =>BD frequency prescribing from 66.2% to 8.75%. Only 27.5% due blood monitoring to be followed-up compared to 90.8% overdue 6months prior.
Within 6 months at the 2nd Practice, we had increased <=1OD frequency prescribing from 42.3% to 91.6%; Reduced =>BD frequency prescribing from 57.7% to 8.4%. Only 25.7% due blood monitoring to be followed-up compared to 90.8% overdue 6 months prior.Patients' compliance and quality of life was improved by being educated, reducing the dose/frequency of oral Ferrous preparations taken whilst making improvement in their levels of fatigue in the safest way possible, e.g. preventing unnecessary gastro-intestinal adverse effects and GPs referred patients who had little response to treatment (as per NICE) to specialist clinics.
