Aim COPPS is a computerised outpatient prescription printing system for WP10 prescriptions. It aims to improve the quality and safety of service, as patients will be provided with a legible, complete prescription to take to a community pharmacy of their choice. Patients requiring specialist medicines will have their medicines dispensed more promptly by the hospital pharmacy or medicines home care provider. The software ensures prescriptions contain all the required information to allow safe dispensing, reducing frequency of delays. Hospital pharmacy staff have more time to explain their medicines to patients, promoting shared decision making and improved adherence leading to better health outcomes and reduced waste and harm; provide information at the time of prescribing to increase adherence to agreed care pathways and prescribing practice. It facilitates attribution of prescribing, improves governance and is more easily audited and reported; capture the costs of medicines dispensed for out-patients which will be measured using information from the hospital pharmacy computer system and CASPA.
The aim of this audit was to evaluate the effect the introduction of COPPS has had on compliance with the UHB formulary, local melatonin pathway and its impact on expenditure for melatonin within the community child health clinic. The pathway states that the starting dose is 2 mg Circadin® tablet or liquid melatonin 1 mg/1 ml if necessary for individual patients.
Method Community Child Health prescribing data shows their highest expenditure is on melatonin. This was therefore chosen to test the impact of COPPS for a pilot study.
Six months prescribing data (September 14–March 15) was obtained from COPPS. This was compared to data obtained for WP10's from hospital forms analysis for the same months the previous year (September 13–March 14)
Results A 55% reduction was seen in the prescribing of non-formulary melatonin and a reduction in expenditure on melatonin by 18% or £16,000. The estimated annual reduction is £23,000.
There was also a significant increase in adherence to the agreed medication pathway for melatonin.
Conclusion COPPS provides information for establishment of a robust and expediated audit of medication costs and pathway compliance as shown by the melatonin results. It encourages prescribers to pick medicines from the UHB formulary and provides information that can be used to assess compliance to agreed pathways. In addition pharmacies are provided with accurate legible prescriptions and the patient receives printed copy of the prescription for the GP. A similar approach will now be used to assess the data for Attention Deficit Hyperactivity Disorder (ADHD). COPPS has recently been rolled out to another UHB community child health clinic and the local special schools and further outpatient clinics will follow. A patient satisfaction survey in the outpatient clinics will be developed and audited.