This section offers a template for an individual to demonstrate their role within an audit(s) where they are not necessarily the prime instigator. It does not remove the revalidation requirements for an individual’s responsibilities under the quality improvement domain (i.e. within a 5 year cycle either a personal audit, case reviews, review of a teaching programme or the evaluation of the impact of a health initiative).
|Title of audit||Co-prescribing of folic acid with Methotrexate|
|Why was this audit performed||A patient saw one of my partners with nausea and vomiting. She was taking Methotrexate for her RA but not taking folic acid supplementation – he brought this up in a practice meeting and I must admit that I was not aware of the evidence to support the co-prescribing|
|Main outcomes||My partner originally found that only 62% of our patients were co-prescribed folic acid with Methotrexate.|
|Personal role within the audit||I was involved in seeing 3 of the patients who were not on a co-prescription – all of whom had at least some symptoms of gastric upset or sore mucous membranes|
|Change in personal practice?||I will endeavour to ensure that whenever I sign a repeat prescription for Methotrexate that I check that the patient is taking folic acid.|
|Any developmental needs identified||This has brought home to me that I really am a little rusty around all of the DMARDs and their monitoring. We have local shared care protocols that the practice has a system in place to monitor these. I think I could do with updating my knowledge in this area and I will note this down in my PDP|
|What has this process meant for me?||I really am someone who is a bit reluctant to become involved in audit myself. This audit however has shown me that real improvements in patient care can be made through this process. The three patients I was personally involved in were showing signs of Methotrexate toxicity and I know that at least one of them is feeling much better after the co-prescription. I think that as well as learning more about the DMARDs I will audit the blood and urine monitoring of our patients on these potentially toxic agents.|