Drug prescribing system could boost patient safety

July 31, 2012, University of Birmingham

(Medical Xpress) -- Research led by the University of Birmingham has shown that a specialised drug prescribing system could help to prevent a repetition of the notorious 2002 killings of elderly patients by nurse Colin Norris.

A nurse at the Leeds General Infirmary and St James Hospitals, Norris was convicted in 2008 of murdering four using insulin, which lowered their and led to their deaths. The condition of a concentration is known as .

One question raised by the case was how likely it is for so many patients to suffer from hypoglycaemia, a condition that is rare in patients if they are not being treated for diabetes or in .

Researchers at the University of Birmingham and Hospital Birmingham (QEHB) have analysed information on 37,898 inpatients to establish how commonly hypoglycaemia occurs among non-diabetic patients on general wards.

The study, which was funded by the National Institute for Health Research (NIHR) via the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Birmingham and Black Country, highlights the Birmingham Health Partners initiative between the University and University Hospitals Birmingham NHS Trust.

They confirmed that significant hypoglycaemia is rare in non-diabetic patients, but also identified the potential for the hospital’s electronic prescribing system to spot unexplained clusters of the condition.

This could enable clinicians to spot the sort of misuse of insulin which led to the deaths of patients under the care of Colin Norris and other convicted killers.

In 1991 nurse Beverley Allitt was found guilty of murdering four children and trying to kill another nine at a hospital in Lincolnshire. In 2006 staff nurse Benjamin Geen was convicted of murdering two of his patients and attacking 15 others with injections including insulin at a hospital in Oxfordshire.

Dr Krishnarajah Nirantharakumar, a clinical research fellow at the University, led the research, which used the Prescribing, Information and Communications System (PICS) to look at hypoglycaemia patients.

“We looked back at the rate of hypoglycaemia in non- outside critical care for 2010, and we found that it was very rare: only 13 in every 10,000 admissions below a value of 2.7mmol/l. We then analysed the case notes of the patients whose blood glucose concentration was below this value and found most had plausible medical explanations in the case notes,” says Dr Niranthakumar.

“Then, because it was shown to be so rare, we questioned whether we could identify these patients using PICS while they’re with us. If so, then it would be a way of increasing vigilance for the misuse of insulin like in the Colin Norris case.”

Dr Jamie Coleman, a consultant clinical pharmacologist at QEHB, says the potential for increasing patient safety is a further benefit of an already successful system.

“We have very good information systems that can provide retrospective surveillance data like this, but these systems also provide secondary benefits with automatic collection of data which may allow a greater degree of surveillance for patient safety.” says Dr Coleman.

“Within our organisation there were, ultimately, no unexplained cases but the potential is there to improve safety further.”

Explore further: Severe hypoglycemia cause identified

More information: The research, “Hypoglycaemia in Non-Diabetic In-Patients: Clinical or Criminal?” is available on-line on the PLoS ONE website: www.plosone.org/article/info%3 … journal.pone.0040384

Related Stories

Severe hypoglycemia cause identified

October 6, 2011
Cambridge scientists have identified the cause of a rare, life-threatening form of hypoglycaemia. Their findings, which have the potential to lead to pharmaceutical treatments for the disorder, were published today in the ...

New drug improves glucose control without increasing risk of hypoglycemia in type 2 diabetes patients

February 26, 2012
TAK-875, a new treatment for type 2 diabetes, improves glycaemic (blood sugar) control and is equally as effective as the sulphonylurea glimepiride (a common drug treatment) but has a significantly lower risk of hypoglycaemia ...

Women are more prone to hypoglycaemia than men

June 27, 2012
Just how important a gender-specific perspective and the personalised treatment of illnesses are between men and women is being demonstrated by two current studies at the MedUni Vienna, which are being led by Alexandra Kautzky-Willer ...

For diabetics not on insulin, self-monitoring blood sugar has no benefit

January 20, 2012
For type 2 diabetics who are not on insulin, monitoring their blood sugar does little to control blood sugar levels over time and may not be worth the effort or expense, according to a new evidence review.

Recommended for you

In most surgery patients, length of opioid prescription, number of refills spell highest risk for misuse

January 17, 2018
The possible link between physicians' opioid prescription patterns and subsequent abuse has occupied the attention of a nation in the throes of an opioid crisis looking for ways to stem what experts have dubbed an epidemic. ...

Patients receive most opioids at the doctor's office, not the ER

January 16, 2018
Around the country, state legislatures and hospitals have tightened emergency room prescribing guidelines for opioids to curb the addiction epidemic, but a new USC study shows that approach diverts attention from the main ...

FDA bans use of opioid-containing cough meds by kids

January 12, 2018
(HealthDay)—Trying to put a dent in the ongoing opioid addiction crisis, the U.S. Food and Drug Administration on Thursday slapped strict new restrictions on the use of opioid-containing cold and cough products by kids.

Taking ibuprofen for long periods found to alter human testicular physiology

January 9, 2018
A team of researchers from Denmark and France has found that taking regular doses of the pain reliever ibuprofen over a long period of time can lead to a disorder in men called compensated hypogonadism. In their paper published ...

Nearly one-third of Canadians have used opioids: study

January 9, 2018
Nearly one in three Canadians (29 percent) have used "some form of opioids" in the past five years, according to data released Tuesday as widespread fentanyl overdoses continue to kill.

Growing opioid epidemic forcing more children into foster care

January 8, 2018
The opioid epidemic has become so severe it's considered a national public health emergency. Addiction to prescription painkillers, such as oxycodone and morphine, has contributed to a dramatic rise in overdose deaths and ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.