Medicine Safety and Effective Healthcare Research

Avoiding patient harm through the application of prescribing safety indicators in English general practices (PRoTeCT)


The overall aim of the PRoTeCT study is to evaluate two different approaches aimed at improving the safety of prescribing medicines in English general practices, and generate NHS policy recommendations.

The PRoTeCT research programme is funded by the National Institute for Health Research (NIHR) Programme Grant for Applied Research (PGfAR) and will run from March 2017 to August 2021.

How will this be achieved?

In the PRoTeCT study the two different approaches to protect patients who may be at an increased risk of harm from their medicines will be evaluated through a series of four linked Work Packages (WPs) and an economic evaluation.

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Work Packages

Work Package 1: Measuring serious harm, and economic impact, associated with hazardous prescribing (Lead: Professor Darren Ashcroft)

Further information on WP1

Work Package 2: Evaluating the effectiveness and cost-effectiveness of an intervention involving the introduction of a set of prescribing safety indicators to computerised clinical decision support (CDS) software (OptimiseRx) in reducing hazardous prescribing in general practices (Lead: Professor Niels Peek)

Further information on WP2

Work Package 3: Evaluating the effectiveness and cost-effectiveness of a pharmacist-led IT-based intervention (PINCER) when widely implemented in general practice to reduce the prevalence of patients exposed to hazardous prescribing, and the incidence of serious harm (Lead: Professor Tony Avery)

Further information on WP3

Work Package 4: Generating recommendations for national roll-out of prescribing safety indicator based interventions i.e. CDS software (WP2) and PINCER (WP3) by developing learning about the key technical, organisational and policy factors that influence sustained implementation and operation in general practice settings (Leads: Dr Richard Keers, Professor Aziz Sheikh and Professor Justin Waring) 

Further information on WP4

Economic evaluation: Determine whether the approaches described above to the use of prescribing safety indicators are a cost-effective way of reducing hazardous prescribing (and avoiding patient harm).  More precise models will be developed and incorporated (in WP1) to better determine the economic impact of both CDS (WP2) and PINCER (WP3) to enable the NHS to make more informed investment decisions (WP4) (Lead: Professor Rachel Elliott)

Further information on economic evaluation



Professor Tony Avery
Division of Primary Care
University of Nottingham School of Medicine
13th Floor, Tower Building, University Park
Nottingham NG7 2RD

T: +44 (0) 115 823 1010 


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The PRoTeCT research study is funded by the National Institute for Health Research Programme Grants for Applied Research award (PGfAR) RP-PG-1214-20012.

Any views expressed on this website are those of the PRoTeCT team and not necessarily those of the NIHR or the Department of Health and Social Care.

Medicine Safefy and Effective Healthcare Research

The University of Nottingham
School of Medicine

telephone: +44 (0) 115 823 0209