Value of drug diligence

01 September 2012

Researchers have shown that a specialised drug prescribing system could help prevent a repetition of the notorious 2002 killings of elderly patients by nurse Colin Norris.

Norris was convicted in 2008 of murdering four patients using insulin, which lowered their blood glucose levels.

The condition of a low blood glucose concentration is known as hypoglycaemia.

One question raised 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 critical care.

The study was funded by the National Institute for Health Research (NIHR) via CLAHRC for Birmingham and Black Country.

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.

Dr Krishnarajah Nirantharakumar, a clinical research fellow at the University of Birmingham, 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-diabetic patients outside critical care for 2010, and we found that it was very rare.

“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.”

Dr Jamie Coleman, a consultant clinical pharmacologist at QEHB, said the potential for increasing patient safety is a further benefit.

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