Medicine Safety and Effective Healthcare Research

Work package 3: the PINCER intervention

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.


To evaluate the effectiveness of PINCER when widely implemented in general practice to:

  • Reduce the prevalence of patient exposure to hazardous prescribing
  • Reduce the incidence of serious harm in patient are risk of hazardous prescribing 
  • Provide value for money for the NHS

Setting and participants

General practices in the East Midlands of England


Design: non-randomised multicentre incomplete stepped-wedged design whereby the intervention is introduced to successive groups of general practices (clustered in participating CCGs) in predefined ‘steps’.


  • Primary: the number and proportion of patients in each general practice exposed to at least one type of hazardous prescribing
  • Secondary: include serious harm associated with hazardous prescribing, hospital admission, and mortality

WP3 team members

  • Professor Tony Avery (lead)
  • Professor Rachel Elliott
  • Dr Sarah Rodgers
  • Dr Amy Taylor
  • Professor Darren Ashcroft
  • Professor Tjeerd van Staa
  • Dr Sarah Armstrong
  • Mrs Mindy Bassi
  • Mr Antony Chuter
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Medicine Safefy and Effective Healthcare Research

The University of Nottingham
School of Medicine

telephone: +44 (0) 115 823 0209