Drug prescribing system could boost patient safety

July 31, 2012

(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

Glucocorticoids offer long-term benefits for patients with Duchenne muscular dystrophy

November 22, 2017
Glucocorticoids, a class of steroid hormone medications often prescribed to patients with Duchenne muscular dystrophy (DMD), offer long-term benefits for this disease, including longer preservation of muscle strength and ...

Baby-boomers and millennials more afflicted by the opioid epidemic

November 21, 2017
Baby-boomers, those born between 1947 and 1964, experienced an excess risk of prescription opioid overdose death and heroin overdose death, according to latest research at Columbia University's Mailman School of Public Health. ...

Sensor-equipped pill raises technological, ethical questions

November 17, 2017
The first drug with a sensor embedded in a pill that alerts doctors when patients have taken their medications was approved by the Food and Drug Administration, raiding issues involving privacy, cost, and whether patients ...

New painkillers reduce overdose risk

November 16, 2017
Scientists on the Florida campus of The Scripps Research Institute (TSRI) have developed new opioid pain relievers that reduce pain on par with morphine but do not slow or stop breathing—the cause of opiate overdose.

Separating side effects could hold key for safer opioids

November 16, 2017
Opioid pain relievers can be extremely effective in relieving pain, but can carry a high risk of addiction and ultimately overdose when breathing is suppressed and stops. Scientists have discovered a way to separate these ...

US regulators approve first digital pill to track patients

November 14, 2017
U.S. regulators have approved the first drug with a sensor that alerts doctors when the medication has been taken, offering a new way of monitoring patients but also raising privacy concerns.

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.