Of note, the audit did not account for observer bias from patients completing the questionnaires as part of Hawthorne Effect. Results show a clear inclination towards self-medicating, however majority of patients were frustrated at being unable to freely access their Insulin prior to meals, and being dependent on scheduled

medication ward rounds before receiving their Insulin dose. There is debate as to whether delayed insulin administration has an adverse effect on a patient’s health. All health-professionals that prescribe, handle or administer insulin must now complete a mandatory NHS Diabetes E-learning module on the safe use of Insulin. Further research would be required to prove its effectiveness and positive impact on patient outcomes. 1. Lamont T, Cousins D, Hillson R, Bischler A, Terblanche click here M. Safer Administration of insulin: summary of a safety report

form the Atezolizumab National Patient Safety Agency.?TBMJ 2010;341:c5269 M. Boyda, D. Jonesa, K. Solankia, S. Rakhejaa, C. Tonga, G. Tomlinsonb, K. O’Kellyc, R. Abeyratnec, T. Masudc aDivision for Social Research in Medicines and Health, The School of Pharmacy, University of Nottingham, Nottingham, UK, bClinical Quality, Risk & Safety Team, Nottingham University Hospitals NHS Trust, Nottingham, UK, cHealth Care of Older Persons Directorate, Nottingham University Hospitals NHS Trust, Nottingham, UK The STOPP/START criteria are a useful tool in identifying inappropriate prescribing or prescribing omissions in patients over 65. Retrospective analysis of patient notes was used to identify STOPP/START violations in patients Megestrol Acetate discharged from the Health Care of Older Persons (HCOP) directorate. Secondary care clinicians reduce inappropriate prescribing between admission and discharge.

Prescribing in older patients is challenging due to factors such as multiple morbidities, polypharmacy and changes in pharmacodynamic and pharmacokinetic profiles. Inappropriate prescribing can result in adverse drug reactions, unnecessary hospital admissions and poor outcomes for patients. In 2008, Gallagher et al. published two tools to assist prescribing for older patients: Screening Tool of Older Persons’; Prescriptions (STOPP) and Screening Tool to Alert to Right Treatment (START).1 These tools comprised 65 indicators to identify potentially inappropriate prescriptions and 22 prescribing indicators for potential prescribing omissions respectively. In a previous audit in the same hospital trust conducted in April-August 2012, 105 patients were audited and it was shown that 85% of patients had one or more inappropriate prescriptions on admission and 74% on discharge. As a result of this previous audit, bespoke training on STOPP/START was introduced by the trust.