Staff Profile:Dr Rachel Howard

Name:

Dr Rachel Howard

Job Title:

Lecturer, Pharmacy Practices

Responsibilities:

• Outreach coordinator for Pharmacy
• Module convenor for Pharmacy Practice 4: Advanced Pharmacy Practice

Areas of Interest:

Background

Preventable drug-related morbidity is responsible for a median of 4.3% of admissions to hospital in the Western developed world. In addition, a median of 1.8% of patients will experience at least one preventable adverse drug event during a hospital stay.

Since the publication of "To err is human" by the Institute of Medicine in the US in 1999 and "Organisation with a memory" by the Department of Health in 2001, there is an increasing body of research exploring the types of adverse drug events experienced by patients, how these events occur, and how they can be avoided in the future. My research contributes to this body of knowledge.

Prior research

My research to date has included:

• A large chart review study of the underlying drug causes of preventable admissions to hospital (funded with £24,000 from Wyeth)
• A qualitative exploration of the underlying causes of preventable drug-related admissions to hospital (funded with £10,000 from the Pharmacy Practice Research Trust)
• A systematic review of the most common drug causes of preventable hospital admissions (funded with NHS R&D money)
• Producing a draft design specification for NHS IT systems to minimise risk of harm to patients from medication, funded with £10,000 from Connecting for Health (led by the University of Nottingham)
• The PINCER trial (a large cluster randomised trial comparing the effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practice), funded with £580,000 from the Patient Safety Research Programme (led by the University of Nottingham, in collaboration with the Universities of Machester and Edinburgh)
• An exploration of hospital pharmacist communication with doctors about prescribing problems, funded with £500 Hugh McGavock Bursary and £1000 from the University of Reading

• The PRACtICe Study: Investigating the prevalence and causes of prescribing errors in general practice, funded with £100,000 from the General Medical Council (led by University of Nottingham, in collaboration with the University of Hertfordshire and London School of Pharmacy).

Present research interests

At present I am working on the following projects:

• An exploration of communication between junior doctors and hospital pharmacists
• An evaluation of electronic prescribing at the Royal Berkshire Hospital, Reading
• An exploration of the use of complementary and alternative medicines by oncology and palliative care patients in England
• An exploration of cancer patients experiences of using of herbal medicines at Arokhayasarn in Thailand

I am keen to continue my research into medication errors, preventable adverse drug events, and developing strategies to avoid them.

Research groups / Centres:

Publications:

Y

Jump to: 2013 | 2012 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2003

Number of items: 24.

2013

• Avery, A., Ghaleb, M., Barber, N., Franklin, B., Armstrong, S., Serumaga, B., Dhillon, S., Freyer, A., Howard, R., Talabi, O. and Mehta, R. (2013) The prevalence and nature of prescribing and monitoring errors in English general practice – a retrospective case note review. British Journal of General Practice. ISSN 0960-1643 (In Press)
• Sadler, S., Rodgers, S., Howard, R., Morris, C. J. and Avery, A. J. (2013) Training pharmacists to deliver a complex information technology intervention (PINCER) using the principles of educational outreach and root cause analysis. International Journal of Pharmacy Practice. ISSN 0961-7671 doi: 10.1111/ijpp.12032
• Howard, R., Rodgers, S., Avery, A. J. and Sheikh, A. (2013) Description and process evaluation of pharmacists’ interventions in a pharmacist-led information technology-enabled multicentre cluster randomised controlled trial for reducing medication errors in general practice (PINCER trial). International Journal of Pharmacy Practice. ISSN 0961-7671 (In Press)
• Thomas, S., McDowell, S., Hodson, J., Nwulu, U., Howard, R., Avery, A., Slee, A. and Coleman, J. (2013) Developing consensus on hospital prescribing indicators of potential harms amenable to decision support. British Journal of Clinical Pharmacology. ISSN 0306-5251 (In Press)

2012

• Howard, R. and Howard, P. (2012) GP guide to drugs used in palliative care: psychostimulants. Prescriber, 23 (21). pp. 47-51. ISSN 0959-6682 doi: 10.1002/psb.984
• Howard, R. and Howard, P. (2012) What GPs need to know about palliative-care drugs : methadone. Prescriber, 23 (18). pp. 34-38. ISSN 0959-6682 doi: 10.1002/psb.959
• Howard, R. L. and Howard, P. D. (2012) What GPs need to know about palliative-care drugs: ketamine. Prescriber, 23 (12). pp. 43-46. ISSN 0959-6682 doi: 10.1002/psb.933
• Avery, A. A., Barber, N., Ghaleb, M., Dean Franklin, B., Armstrong, S., Crowe, S., Dhillon, S., Freyer, A., Howard, R., Pezzolesi, C., Serumaga, B., Swanwick, G. and Olanrewaju, T. (2012) Investigating the prevalence and causes of prescribing errors in general practice: the PRACtICe Study. Project Report. General Medical Council pp227.
• Avery, A. A., Rodgers, S., Cantrill, J. A., Armstrong, S., Cresswell, K., Eden, M., Elliott, R. A., Howard, R., Kendick, D., Morris, C. J., Prescott, R. J., Swanwick, G., Franklin, M., Putman, K., Boyd, M. and Sheikh, A. (2012) A pharmacist-led information technology intervention for medication errors (PINCER): a multicentre, cluster randomised, controlled trial and cost-effectiveness analysis. The Lancet, 379 (9823). pp. 1310-1319. ISSN 0140-6736 doi: 10.1016/S0140-6736(11)61817-5

2010

• Avery, A. J., Rodgers, S., Cantrill, J. A., Armstrong, S., Boyd, M., Cresswell, K., Eden, M., Elliott, R., Franklin, M., Hippisley-Cox, J., Howard, R., Kendrick, D., Morris, C. J., Murray, S. A., Prescott, R. J., Puttman, K., Swanwick, G., Tuersley, L., Turner, T., Vinogradova, Y. and Sheikh, A. (2010) PINCER trial: a cluster randomised trial comparing the effectiveness and cost-effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices. Project Report. Patient Safety Research Portfolio, Birmingham.

2009

• Howard, R. L. and Avery, A. J. (2009) Medicines management. In: Hurwitz, B. and Sheikh, A. (eds.) Health care errors and patient safety. Blackwell, Oxford, pp. 150-165. ISBN 9781405146432
• Avery, A.J., Rodgers, S., Cantrill, J.A., Armstrong, S., Elliott, R., Howard, R., Kendrick, D., Morris, C.J., Murray, S.A., Prescott, R.J., Cresswell, K. and Sheikh, A. (2009) Protocol for the PINCER trial: a cluster randomised trial comparing the effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices. Trials, 10 (28). ISSN 1745-6215 doi: 10.1186/1745-6215-10-28

2008

• Howard, R., Avery, A. and Bissell, P. (2008) Causes of preventable drug-related hospital admissions: a qualitative study. Quality & Safety in Health Care, 17 (2). pp. 109-116. ISSN 1475-3898 doi: 10.1136/qshc.2007.022681
• Whalley, B.J., Fletcher, K.E., Weston, S.E., Howard, R.L. and Rawlinson, C.F. (2008) Foundation in pharmacy practice. Pharmaceutical, London. ISBN 9780853697473
• Howard, R. L. (2008) A qualitative exploration of the underlying causes of preventable drug-related morbidity in primary care, resulting in hospitalisation. Report. Pharmacy Practice Research Trust , London. pp61. ISBN 9780955696947

2007

• Howard, R.L., Avery, A.J., Slavenburg, S., Royal, S., Pipe, G., Lucassen, P. and Pirmohamed, M. (2007) Which drugs cause preventable admissions to hospital? A systematic review. British Journal of Clinical Pharmacology, 63 (2). pp. 136-147. ISSN 0306-5251 doi: 10.1111/j.1365-2125.2006.02698.x

2006

• Howard, R.L. (2006) Beta-blocker selectivity and airways obstruction. Prescriber, 17 (22). pp. 52-55. ISSN 0959-6682
• Howard, R.L., Avery, A.J. and Bissell, P. (2006) Description of a multifaceted strategy for recruiting general practitioners and community pharmacists to talk about medication errors. International Journal of Pharmacy Practice, 14 (3). pp. 205-209. ISSN 2042-7174 doi: 10.1211/ijpp.14.3.0007
• Howard, R.L. (2006) NSAIDs: GI risk with a past history of peptic ulceration. Prescriber, 17 (24). pp. 29-31. ISSN 0959-6682
• Howard, R.L. and Avery, A.J. (2006) Pharmacist-led medication reviews can reduce patient morbidity? Age and Ageing, 35 (6). pp. 555-556. ISSN 0002-0729 doi: 10.1093/ageing/afl110
• Morris, C.J., Cantrill, J.A., Avery, A.J. and Howard, R.L. (2006) Preventing drug related morbidity: a process for facilitating changes in practice. Quality & Safety in Health Care, 15 (2). pp. 116-121. ISSN 1475-3898 doi: 10.1136/qshc.2005.014597
• Howard, R. L., Avery, A. J. and Morris, C. J. (2006) Using chart review and clinical databases to study medical error. In: Walshe, K. and Boaden, R. (eds.) Patient safety: research into practice. Open University Press, Maidenhead, pp. 118-129. ISBN 9780335218530

2005

• Kroese, W. L. G., Avery, A. J., Savelyich, B. S. P., Brown, N. S., Schers, H., Howard, R., Hippisley-Cox, J. and Horsfield, P. (2005) Assessing the accuracy of a computerized decision support system for digoxin dosing in primary care: an observational study. Journal of Clinical Pharmacy and Therapeutics, 30 (3). pp. 279-283. ISSN 1365-2710 doi: 10.1111/j.1365-2710.2005.00650.x

2003

• Howard, R., Avery, A.J., Howard, P. and Partridge, M. (2003) Investigation into the reasons for preventable drug related admissions to a medical admissions unit: observational study. Quality & Safety in Health Care, 12 (4). pp. 280-285. ISSN 2044-5423 doi: 10.1136/qhc.12.4.280

This list was generated on Tue Jun 18 21:08:57 2013 BST.

Grants awarded

1. 2009: Part of team awarded £100,000 by the General Medical Council for the PRACtICe Study: Investigating the prevalence and causes of prescribing errors in general practice.
2. 2007: Awarded £1000 from the University of Reading Research Endowment Trust Fund for Social Sciences to conduct as questionnaire survey of communication between hospital pharmacists and doctors about prescribing problems. [PI]
3. 2007: Awarded the Hugh McGavock Bursary for best abstract (£500).
4. 2006: Part of team awarded £10,000 by Connecting for Health & National Patient Safety Agency to develop a draft design specification for NHS IT systems to minimise risk of harm to patients from medication.
5. 2005: Part of team awarded £580,000 by the Patient Safety Research Council for the PINCER trial "A cluster randomised trial comparing the effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices."
6. 2003: Galen Award, Royal Pharmaceutical Society of Great Britain. £10,000 to complete a qualitative exploration of the underlying causes of preventable drug related admissions to a teaching hospital in Nottingham.