Audit-based education to implement NICE clinical recommendations of things 'not to do' in people with cardiometabolic diseases: a two-round cluster randomised trial
The National Institute for Health and Care Excellence (NICE) provides guidelines on treatments that doctors should avoid because they may be unhelpful or cause side effects. However, busy family doctors do not always have time to track every update. This study is testing an educational tool for GP surgeries in England. The tool includes an online dashboard that tracks prescriptions and short training webinars for clinic staff. Researchers want to see if this helps doctors avoid outdated or unnecessary treatments for people living with two or more heart or metabolic conditions, such as diabetes and high blood pressure. Patients do not need to attend extra clinic visits. Instead, researchers use anonymised GP records to see if care becomes safer over time.
At a glance
What is this study about?
Healthcare experts at NICE have identified hundreds of medical practices and treatments that doctors should avoid. These 'Do-Not-Do' recommendations exist because newer medical research shows that certain medications or tests either do not work well or might cause harmful side effects. Because family doctors are very busy and care for people with many different needs, keeping up with every single rule can be challenging.
This study focuses on people who live with more than one cardiometabolic condition. This includes illnesses affecting the heart, circulation, or metabolism, such as type 2 diabetes, high blood pressure, or heart disease. Managing several conditions often means taking lots of different tablets, which increases the chance of drug interactions or side effects.
To help doctors make the safest choices, researchers at the University of Oxford have created a special support package for GP surgeries. It gives clinic staff regular reports and training on treatments they should avoid. By comparing practices that use the tool with those giving usual care, the study hopes to discover if this support leads to safer prescribing and fewer hospital visits.
Key takeaways
- The study tests an educational tool to help GPs avoid prescribing unnecessary treatments.
- It focuses on adults aged 18 to 64 who have two or more heart or metabolic conditions.
- Patients do not need to take new drugs, undergo tests, or attend extra visits.
- The study relies on securely protected, anonymised GP health records.
- The main goal is to improve patient safety, reduce side effects, and cut hospital visits.
Who may be eligible?
This study is designed around GP practices rather than individual patient sign-ups. To be included in the review, you must be an adult aged between 18 and 64 and be registered with an English GP surgery that is part of the Oxford-Royal College of General Practitioners research network.
You also need to have been diagnosed with at least two cardiometabolic conditions. Common examples include type 2 diabetes, high blood pressure, heart disease, or past stroke.
Because this study looks at how clinics work behind the scenes, you do not need to apply to join. If your surgery is taking part, your de-identified medical records may be reviewed automatically to check prescription safety.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- I am aged between 18 and 64 years old.
- I have been diagnosed with two or more heart, circulatory, or metabolic conditions (such as diabetes, high blood pressure, or heart disease).
- I am registered with a GP surgery in England.
- My GP surgery is part of the Oxford-Royal College of General Practitioners research network.
What does participation involve?
Taking part in this study does not require any extra effort from you. There are no additional doctor appointments, hospital visits, blood tests, or trial medications to take. Your day-to-day care will continue as normal.
The GP practice itself is the participant. Some surgeries will receive the new training webinars and safety tracking dashboards, while others will continue with their usual routine for 12 months. Researchers will look at securely protected health records over the study period to see whether prescription safety improves. Your personal details, like your name and address, are kept strictly confidential and removed before any information is analysed.
Potential risks and benefits
Locations (1)
- University OxfordApproximateOxford, England
Common questions
What is a 'Do-Not-Do' recommendation?
It is official guidance from NHS experts identifying medical tests or treatments that research shows offer little benefit or may cause unnecessary harm.
Do I have to take a new trial medicine?
No. This study does not test any new or experimental drugs. It only helps doctors follow existing safety guidance for current treatments.
Will I need to attend extra GP appointments?
No. The study focuses on how GP surgeries review their prescribing data. You do not need to attend extra check-ups or undergo extra tests.
Is my personal medical data safe?
Yes. Researchers use de-identified records, meaning your name, address, and anything else that identifies you is completely removed before review.
Can I opt out of having my records used?
Yes. You can speak to your GP surgery at any time to register for the National Data Opt-Out, which stops your records being used for research.
How to find out more
Simon de Lusignan
Always speak to your GP or specialist before deciding to take part in a study.
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