Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study

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One approach to reducing medication related harm is to develop interventions that improve prescribing. Audit and feedback is one such intervention that has been shown to have an effect on professional behaviour. With advancements in the data infrastructure of primary care it is now possible to harness routine prescribing data for ongoing and up-to-date comparative benchmarking. The aim of this study was to assess the usability and usefulness of a prescribing safety dashboard developed in Irish general practice. Methods Practices utilising the data analytics platform, MedVault opted in to share anonymous prescription data to enable the development of the prescribing safety dashboard. Participants from these practices who had previously expressed an interest in taking part in this qualitative study will be formally invited to take part. Recruited prescribers will take part in an online interview with a think aloud process where they will share their screen as they navigate the dashboard and verbalise their thoughts. This will be followed by a semi-structured interview where their views on prescribing safety and receiving feedback on prescribing will be explored. For the think aloud process, screen recordings will be reviewed alongside the transcripts, and analysed using Nielsen’s five quality components of usability: learnability, efficiency, memorability, error recovery and satisfaction as a framework. An inductive thematic approach will be used to analyse GPs’ perspectives on prescribing safety and feedback. Discussion This study will explore the usability and acceptability of a prescribing quality and safety dashboard. To design future interventions, policies, and quality improvement initiatives that make use of routine data, it is essential to understand how GPs engage with and use these tools. This understanding can help ensure such initiatives are developed in ways that maximise relevance, usability, and engagement. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://hrbopenresearch.org/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://hrbopenresearch.org/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://hrbopenresearch.org/articles/8-67", "name": "Developing and assessing the usability of a prescribing quality and..." } } ] } Home Browse Developing and assessing the usability of a prescribing quality and... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article McCarthy C, Fahey T, Moriarty F et al. Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.12688/hrbopenres.14181.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] Caroline McCarthy https://orcid.org/0000-0002-2986-5994 1 , Tom Fahey https://orcid.org/0000-0002-5896-5783 1 , Frank Moriarty https://orcid.org/0000-0001-9838-3625 2 , Michelle Flood 2 , Eimear Loftus 1 , Barbara Clyne 3 Caroline McCarthy https://orcid.org/0000-0002-2986-5994 1 , Tom Fahey https://orcid.org/0000-0002-5896-5783 1 , [...] Frank Moriarty https://orcid.org/0000-0001-9838-3625 2 , Michelle Flood 2 , Eimear Loftus 1 , Barbara Clyne 3 PUBLISHED 18 Jun 2025 Author details Author details 1 Department of General Practice, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin 2, Ireland 2 School of Pharmacy and Biomolecular Sciences, (RCSI) University of Medicine and Health Sciences, Dublin 2, Ireland 3 Department of Public Health & Epidemiology, RCSI, University of Medicine and Health Sciences, Dublin 2, Ireland Caroline McCarthy Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Tom Fahey Roles: Conceptualization, Investigation, Methodology, Writing – Review & Editing Frank Moriarty Roles: Conceptualization, Formal Analysis, Methodology, Writing – Review & Editing Michelle Flood Roles: Conceptualization, Formal Analysis, Methodology, Writing – Review & Editing Eimear Loftus Roles: Investigation, Methodology, Writing – Review & Editing Barbara Clyne Roles: Conceptualization, Formal Analysis, Methodology, Supervision, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background The third WHO Global patient safety challenge, “Medication Without Harm” aims to reduce severe avoidable medication related ham by 50% globally. One approach to reducing medication related harm is to develop interventions that improve prescribing. Audit and feedback is one such intervention that has been shown to have an effect on professional behaviour. With advancements in the data infrastructure of primary care it is now possible to harness routine prescribing data for ongoing and up-to-date comparative benchmarking. The aim of this study was to assess the usability and usefulness of a prescribing safety dashboard developed in Irish general practice. Methods Practices utilising the data analytics platform, MedVault opted in to share anonymous prescription data to enable the development of the prescribing safety dashboard. Participants from these practices who had previously expressed an interest in taking part in this qualitative study will be formally invited to take part. Recruited prescribers will take part in an online interview with a think aloud process where they will share their screen as they navigate the dashboard and verbalise their thoughts. This will be followed by a semi-structured interview where their views on prescribing safety and receiving feedback on prescribing will be explored. For the think aloud process, screen recordings will be reviewed alongside the transcripts, and analysed using Nielsen’s five quality components of usability: learnability, efficiency, memorability, error recovery and satisfaction as a framework. An inductive thematic approach will be used to analyse GPs’ perspectives on prescribing safety and feedback. Discussion This study will explore the usability and acceptability of a prescribing quality and safety dashboard. To design future interventions, policies, and quality improvement initiatives that make use of routine data, it is essential to understand how GPs engage with and use these tools. This understanding can help ensure such initiatives are developed in ways that maximise relevance, usability, and engagement. READ ALL READ LESS Keywords interactive dashboard, prescribing safety, patient safety, medication optimisation, electronic healthcare records, drug utilisation Corresponding Author(s) Caroline McCarthy ( [email protected] ) Close Corresponding author: Caroline McCarthy Competing interests: No competing interests were disclosed. Grant information: Health Research Board [CSF- 2023-012] The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2025 McCarthy C et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: McCarthy C, Fahey T, Moriarty F et al. Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.12688/hrbopenres.14181.1 ) First published: 18 Jun 2025, 8 :67 ( https://doi.org/10.12688/hrbopenres.14181.1 ) Latest published: 18 Jun 2025, 8 :67 ( https://doi.org/10.12688/hrbopenres.14181.1 ) Introduction Medication-related harm is a major contributor to preventable patient morbidity and healthcare burden 1 , for example almost 9% of emergency department admissions in older people are due to preventable drug related problems 2 . Estimates for the prevalence of sub-optimal prescribing are even higher ranging from 20% to 50% 3 . Internationally, initiatives such as the WHO’s Global Patient Safety Challenge Medication Without Harm recognise this growing problem and aim to reduce avoidable medication-related harm. Alongside direct medication-related harm, overprescribing is a growing concern and refers to the use of medicines that are ineffective, have an unfavourable risk - benefit ratio or do not align with patient preferences. Estimates suggest that up to 10% of medications are overprescribed 4 . Overprescribing is a systemic problem influenced by multiple factors, including pharmaceutical marketing and a lack of transparency in regulation and access to trial data, cultural and societal expectations that position medicines as quick-fix solutions and prescriber attitudes and knowledge. Drug utilisation rates and geographic patterns of variation can help characterise and describe overprescribing 5 . One approach to address high-risk prescribing and overprescribing is to target prescriber behaviour through audit and feedback interventions. There is evidence that audit and feedback interventions have a small but significant effect on health professional behaviour, particularly when repeated and sustained exposure is used 6 . This finding has subsequently been confirmed with suggestions that the current focus should be to systematically test various approaches to the design and development of audit and feedback 7 . With advances in electronic prescribing and data infrastructure, it is now possible to provide real-time, comparative feedback to prescribers about their prescribing patterns relative to their peers 8 . While comparative prescribing dashboards have the potential to influence behaviour, their effectiveness depends on how they are used and engaged with. Given that most prescribing occurs in primary care, targeting this population is likely to have the greatest potential for impact on overall prescribing quality and safety. This study aims to assess how GPs in Ireland engage with and use a prescribing safety dashboard. This will inform the design and implementation of future real-time prescribing feedback interventions. The first objective is to explore how prescribers interact with, interpret, and use the dashboards using a think-aloud approach. The second objective is to assess the perceived usefulness and acceptability of prescribing feedback, both generally and in this specific format, through semi-structured interviews. Methods In this qualitative study, a think-aloud exercise will be performed with prescribers to assess the usability of the interactive prescribing dashboards. Semi-structured online interviews will also be conducted to explore views on the acceptability and usefulness of the dashboards. This study adheres to the Declaration of Helsinki and ethical approval was received from the Irish College of General Practitioners Research Ethics Committee (ICGP_REC_2024_ 2502). All participants will give fully informed written consent. This qualitative study is part of a larger project which aims to explore the use of personal formularies in general practices, how this relates to the quality of prescribing, and how feedback using this information can be delivered to prescribers for comparative benchmarking, see Figure 1 . The process of deriving and feeding back prescribing quality metrics was piloted in a previous study, where participating prescribers received a paper-based report comparing their performance to that of their peers 9 . Figure 1. Project flow diagram. Setting This study is set in general practice in the Republic of Ireland, where there is a mix of eligibility in terms of access to primary care and medicines. Individuals covered under the means tested General Medical Services (GMS) scheme, are eligible for free prescription medicines, with a small co-payment. In 2023 this represented 31% of the population. For those not covered by the GMS scheme there is a monthly threshold of €80 per household for the cost of prescribed medications, beyond which the state covers any further costs 10 . Individuals covered by the GMS scheme, and approximately 10% of the population covered by the Doctor Visit scheme, have access to free GP visits and are registered with a single GP. However, the majority of patients (private patients) pay for GP visits and may not be registered with a single practice, making it challenging to calculate an accurate practice population denominator. Within Europe, the UK and Nordic countries have led the way in advanced e-prescribing infrastructure with a central repository which can then be used for feedback 11 – 13 . In the UK there is routine national level prescribing surveillance where prescribing is actively monitored through structured frameworks, using prescribing data to provide feedback, financial incentives, and targeted interventions for GPs 14 . Ireland relies more on voluntary adherence to Health Service Executive (HSE) guidance. Examples of such guidance include the Preferred Drugs initiative which provides recommendations on the use of preferred drugs within ten common drug classes that are selected based on effectiveness, cost effectiveness and practical considerations such as dosing regimens 15 . Similarly, the HSE Antimicrobial Resistance and Infection Control team has developed guidance for community settings on “green” antibiotics, which are preferred to minimise the risk of anti-microbial resistance and adverse drug reactions 16 . GPs currently receive feedback on benzodiazepine and antibiotic prescribing from the HSE based on dispensing data from the GMS scheme. However, this may not give the full picture compared to GP prescription data which includes both private prescriptions and medicines covered under drug re-imbursement schemes. Dashboard description In collaboration with the data analytics platform, MedVault (a private company that supports general practices in using their clinical data to improve care and manage reimbursement claims), the lead author (CMC) has developed prescribing safety dashboards using Snowflake for data processing and Amazon QuickSight for visualisation. Practices will have ongoing access to their dashboards from February 2025 for six months. Each practice will be able to view their own prescribing data and compare it to aggregate data from other participating practices, see Figure 2 . However, practices will remain anonymous to one another, MedVault and the research team. Figure 2. Sample page from prescribing quality and safety dashboard. The prescribing dashboard was designed to provide insights into prescribing patterns at the practice level. As practices have one unique login, it is not feasible to provide prescriber level feedback. The dashboards will initially display trend data over five years with comparative benchmarking, with a subsequent update in May 2025. Table 1 lists the included metrics with reasons for their inclusion. Table 1. Included prescribing metrics. Metric Expressed as Reason for inclusion Antibiotic prescribing rate Annual rate per 1,000 patients National and international focus on reducing AMR 16 GPs have reived national comparative feedback since July 2018 but this is just for GMS patients 19 Antibiotic appropriateness Annual proportion of all antibiotics that are green National and international focus on reducing AMR 16 GPs have reived national comparative feedback since July 2018 but this is just for GMS patients 19 BZRA prescribing rate Annual rate per 1,000 patients Risk of dependence, harm and street diversion National strategies to address prescribing GPs have reived national comparative feedback since May 2017 but this is just for GMS patients 20 Potent opioid prescribing rate Annual rate per 1,000 patients Ineffective and dose dependent risk of harm when used for chronic pain Ongoing increasing rates of long term opioid prescriptions 21 High-dose PPI prescribing Annual proportion of all PPI prescribing hat is high-dose Potentially inappropriate high dose PPI prescribing is highly prevalent 18 GPs currently do receive feedback on PPI prescribing High-risk NSAID prescribing: anticoagulant Numerator is number of patients with > 1 anticoagulant prescriptions in that year Denominator is the number of these patients with at least one NSAID prescription that year Risk of gastrointestinal bleeding 22 GPs currently do not receive any feedback on this metric High-risk NSAID prescribing: ACEi/ARB AND diuretic Numerator is number of patients with >1 prescription for both an ACEi/ARB and diuretic that year Denominator is the number of these patients with at least one NSAID prescription that year Risk of acute kidney injury 23 GPs currently do not receive any feedback on this metric Preferred drugs prescribing For each of the ten drugs, expressed as a proportion of the total prescribing for that drug group in that year HSE guidance on preferred drugs 15 Potential for cost savings if adhered to 24 Not currently monitored Use of practice formulary Drug Utilization 90% (DU90%) - Number of unique medicines accounting for 90% of practice prescribing for that year. Name and number of prescriptions for each medicine included in the DU90% segment 25 WHO Guide to Good Prescribing recommends use of personal formulary 26 Feasible to apply the DU90% indicator to anonymous prescription data 9 Use of the DU90% in another setting as a tool for feeding back data on prescribing quality acceptable and useful for GPs 27 Abbreviations; AMR; antimicrobial resistance, BZRA; benzodiazepine and z-drug receptor agonists, GMS; general medical services, PPI; proton pump inhibitor, NSAID, non-steroidal anti-inflammatory drug, ACEi; angiotensin converting enzyme inhibitor, ARB; aldosterone receptor blocker, DU90%; drug utilisation 90%, WHO; World Health Organisation Dashboard development Data from participating practices (n=27) were scrubbed from practice servers by MedVault, see Table 2 , and transformed within Snowflake, where key prescribing safety metrics were generated and structured for visualisation. Table 2. Data points included in the analysis. Variable Description Patient ID Anonymous patient ID Clinic ID Anonymous practice ID Prescriber ID Anonymous prescriber ID Prescription issue date Date and time prescription was issued Prescription type GMS or private prescription Drug name Drug name as prescribed (either generic or brand) with strength e.g., Amlodipine 5mg tabs Generic name Generic drug name ATC code WHO ATC code Current repeats The number of times the prescription was issued (typically either 1 for acute items or 3 or 6 for repeat items) Total quantity taken The total number of that drug strength prescribed for that month (e.g., for Amlodipine 5mg this variable would be 30) No of private patients in clinic The number of registered patients with at least one encounter in the previous 3 years (calculated annually) No of GMS patients in clinic The number of registered GMS patients Total number of patients No of private patients + No of GMS patients System The practice management software used by the practice The WHO Anatomical Therapeutic Chemical (ATC) classification system, which categorises medicines according to the organ or system they act on and their therapeutic, pharmacological and chemical characteristics 17 , was used to identify drug groups and classes. There were errors in the WHO ATC code mapping process within practice systems so this was updated using a codebook developed for prior research that mapped branded and generic drug names to WHO ATC codes 18 . Using the high-dose PPI prescribing metric as an example, all PPIs were identified using the ATC code beginning with A02BC. For metrics displayed as prescribing rates, rates were calculated annually using the total practice population, whereby numbers of private patients were calculated by counting individuals who had at least one encounter in the preceding three years. An encounter was defined as any recorded contact with the practice (including a prescription, telephone consultation or nurse consultation). High-dose PPI prescribing was the only metric that required dose information. The relevant dose was identified by searching the drug name variable for dose indicators corresponding to each PPI in the dataset (e.g., '40' for omeprazole, '30' for lansoprazole). For high-risk non-steroidal anti-inflammatory drug (NSAID) prescribing, the anonymous patient ID was used to identify instances where patients who had received more than one prescription for either an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker and a diuretic had also received at least one prescription for a NSAID in the same year. Instances of patients who had received more than one prescription for an anticoagulant and at least one NSAID prescription in the same year were identified in a similar manner. For all comparative metrics, an identical dataset was cloned in Snowflake and imported into QuickSight with row-level permissions applied, ensuring that each practice could only view its own data. This graph was displayed alongside a graph showing data from all practices, allowing each practice to compare its performance with others. The DU90% indicator ( Table 1 ) was calculated on an annual basis for each practice. The total number of unique ATC coded items were counted by practice and by year and then sorted in descending order, so the cumulative proportion of prescribing for each drug could be calculated. Items whereby the cumulative proportion was <90% were identified as belonging in the DU90% segment for that practice in that year. A bar chart displaying all the drugs in descending order of quantity prescribed in each practice DU90% was developed in QuickSight, see Figure 3 . This was the only metric that was not comparative. See extended data for the SQL code used to derive prescribing safety metrics. Figure 3. Practice DU90% segment. Study population General practices in the Republic of Ireland that currently use the MedVault data analytics platform are eligible to participate. While the participating practices represent only a small proportion of practices nationally, they are broadly representative in terms of size and location and use two of the three predominant electronic health record systems in Ireland. MedVault practices who had previously consented to share anonymous prescription data (n=27) and receive interactive prescribing dashboards were asked to consent to be contacted about this qualitative study. Contact details for GPs interested in participating in this qualitative study were stored separately and not linked to prescribing data. For this study a purposive sample of approximately 12 prescribers from different practices will be recruited to ensure a range of perspectives and experiences. This sample size was chosen based on the concept of information power, which suggests that a smaller sample size is sufficient when the sample is specific, the study aim is clearly focused, and the expected quality of dialogue is high 28 . All participants will have relevant experience and the sample will be relatively homogenous, thus ensuring high sample specificity. The narrow aim to evaluate the dashboard usability and the think-aloud method employed are expected to yield high-quality, in-depth data. Participants will be individually recruited and consented. If more than 12 volunteer a diverse sample from within this will be selected. Data collection The lead author (CMC) will conduct think aloud exercises and semi-structured interviews. She is a practicing GP who developed the dashboards. She has an existing professional relationship with GPs from one of the recruited sites but otherwise has no existing relationship with potential participants. Participating GPs will be aware of her professional background and of the fact that she developed the dashboards. Microsoft Teams, will be used to screen and audio record the think aloud exercise and subsequent semi-structured interview. Cameras will be turned off during the session, and no video recordings or facial data will be collected. Only screen activity and audio will be recorded for analysis. Recordings will be transcribed using the live transcription feature, and verified manually. During the think aloud exercise GPs will navigate the dashboards and verbalise their thoughts and reactions in real-time to assess how GPs engage with and interpret their data using these visualisation tools. GPs will be reassured that their individual prescribing data will not be stored or reported and that the purpose of the activity is to assess the usability, layout, and clarity of the dashboards. Screen recordings will be deleted after analysis. The GPs will be given four discrete tasks for the think aloud process. This will be followed by the semi-structured interview, where the topic guide will include questions exploring perspectives on prescribing safety, receiving prescribing feedback and views and opinions of the dashboards, see extended data. This approach will provide insights into the usability of the dashboards and how prescribers interpret and act on the feedback provided. The interview topic guide was developed with multidisciplinary input and iteratively refined based on pilot testing. The estimated duration of the entire interview including the think aloud process is 45 minutes. Analysis Transcripts will be read and re-read to support familiarisation with the data and to capture the context and nuances of participants’ responses (CMC). For the think aloud process, screen recordings will be reviewed alongside the transcripts, with verbal data checked and amended for accuracy. Notations will be added to indicate relevant on-screen activity (e.g. navigation paths, pauses, points of confusion), enabling interpretation of how participants interacted with the dashboard in real time. Coding for the think aloud exercises will focus on understanding GPs' engagement with the dashboards, identifying usability issues, and assessing the interpretation and perceived usefulness of the feedback. This will be done using a deductive coding framework based on Nielsen’s five quality components of usability: learnability, efficiency, memorability, error recovery and satisfaction 29 . These components will form the primary themes, with sub-themes developed from the data. This combined analysis will allow for a richer understanding of usability, layout, and interpretability, by linking verbal feedback with observed behaviour. An inductive thematic approach will be used to explore GPs’ perspectives on prescribing safety and feedback. The analysis will be organised around three broad topic areas: general views on prescribing safety, experiences and perceptions of feedback, and views on the dashboards. Within each area, themes will be developed inductively from the data, allowing patterns to be identified based on participants’ own words and reflections. This approach will allow themes to be developed directly from the data, helping to capture GPs’ ideas and experiences based on the work of Braun and Clarke 30 . The transcripts will be systematically coded, with initial coding identifying key phrases, concepts, and categories that are developed from the data. These codes will then be sorted into broader themes that capture the main topics and patterns across the interviews. Discussion Strengths and limitations The mixed methods approach will strengthen the depth and richness of the findings; with the think-aloud method allowing for the observation of how GPs interact with the dashboards in real-time and the follow-up interview questions probing how GPs reflect on receiving this feedback. The major limitation of this work is the potential for social desirability bias as the lead author and interviewer (CMC) is also a GP and developed the dashboards. This dual role may discourage some participants from expressing criticism or scepticism openly. However, the interviewer’s clinical background and familiarity with the dashboards also enable more informed probing and interpretation of participants’ responses. To mitigate against the risk of biased interpretation of data interviews and codes will be reviewed by a second member of the study group. The interviews will take place within 2–4 weeks of the dashboards being made available. It is anticipated that some GPs will have explored the dashboards, while others may have limited or no exposure. Apart from notifying practices that the dashboards were available, no specific instructions or encouragement to access them were given. Limited exposure prior to the think-aloud exercise may enhance the assessment of usability and clarity. However, this also limits the opportunity for GPs to reflect on or act upon the data, which may reduce the depth of insight gained during the follow-up semi-structured interviews. Implications for practice, policy and research With recent planned enhancements in e-prescribing and the data infrastructure of Irish primary care, this research will provide important insights into how routine data may be harnessed for audit and feedback purposes. Importantly, it will explore the usability of a prototype dashboard and how GPs interact with this form of data-driven support. Patient, public and knowledge user perspectives In March 2023, at the grant proposal stage, the PI (CMC) met with two public and patient involvement (PPI) contributors to discuss the overall research aims of the proposal and how they would be addressed. Their feedback helped shape the initial proposal. The grant’s independent steering committee includes a GP representative, and the PI is also a practicing GP, ensuring that both patient and clinical perspectives are embedded throughout the project. Ethical approval Ethical approval was granted by the Irish College of General Practitioner Research Ethics Committee, 7 th October 2024, ICGP_REC_2024_ 2502. All participants will give fully informed written consent. Data availability statement As this is a study protocol, there is no data associated with this study. Extended data The think aloud tasks, interview guide and SQL code used to generate variables for visualisation in QuickSight are available at: https://doi.org/10.5281/zenodo.15545093 31 Data are available under Creative Commons Attribution 4.0 International Faculty Opinions recommended References 1. Howard RL, Avery AJ, Slavenburg S, et al. : Which drugs cause preventable admissions to hospital? A systematic review. Br J Clin Pharmacol. 2007; 63 (2): 136–47. PubMed Abstract | Publisher Full Text | Free Full Text 2. Oscanoa TJ, Lizaraso F, Carvajal A: Hospital admissions due to adverse drug reactions in the elderly. A meta-analysis. Eur J Clin Pharmacol. 2017; 73 (6): 759–70. PubMed Abstract | Publisher Full Text 3. Moriarty F, Bennett K, Fahey T, et al. : Longitudinal prevalence of potentially inappropriate medicines and potential prescribing omissions in a cohort of community-dwelling older people. Eur J Clin Pharmacol. 2015; 71 (4): 473–82. PubMed Abstract | Publisher Full Text | Free Full Text 4. National overprescribing review report: Good for you, good for us, good for everybody. Department of Health and Social Care, UK, 2021; 22/09/2021. Reference Source 5. Rasmussen L, Wettermark B, Steinke D, et al. : Core concepts in pharmacoepidemiology: measures of drug utilization based on individual-level drug dispensing data. Pharmacoepidemiol Drug Saf. 2022; 31 (10): 1015–26. PubMed Abstract | Publisher Full Text | Free Full Text 6. Ivers N, Jamtvedt G, Flottorp S, et al. : Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012; 2012 (6): Cd000259. PubMed Abstract | Publisher Full Text | Free Full Text 7. Ivers NM, Grimshaw JM, Jamtvedt G, et al. : Growing literature, stagnant science? Systematic review, meta-regression and cumulative analysis of audit and feedback interventions in health care. J Gen Intern Med. 2014; 29 (11): 1534–41. PubMed Abstract | Publisher Full Text | Free Full Text 8. McCarthy C, Moynagh P, Mannion Á, et al. : Effectiveness of interactive dashboards to optimise prescribing in general practice: a systematic review. medRxiv. 2025; 2024.08.22.24312420. Publisher Full Text 9. McCarthy C, Moynagh P, Fahey T, et al. : Core medication use in general practice prescriptions: a pilot study evaluating the Drug Utilization 90% Index in Irish general practice. Br J Clin Pharmacol. 2025; 91 (4): 1241–1249. PubMed Abstract | Publisher Full Text | Free Full Text 10. Mattsson M, Flood M, Wallace E, et al. : Eligibility rates and representativeness of the General Medical Services scheme population in Ireland 2016-2021: a methodological report [version 1; peer review: 2 approved]. HRB Open Res. 2023; 5 : 67. PubMed Abstract | Publisher Full Text | Free Full Text 11. Curtis HJ, Goldacre B: OpenPrescribing: normalised data and software tool to research trends in English NHS primary care prescribing 1998–2016. BMJ Open. 2018; 8 (2): e019921. PubMed Abstract | Publisher Full Text | Free Full Text 12. ePrescribing: an International Review. Health Information and Quality Authority (HIQA), 2018. Reference Source 13. Stroetmann KA, Artmann J, Stroetmann VN, et al. : European countries on their journey towards national eHealth infrastructures - evidence on progress and recommendations for cooperative actions - Final European progress report. 2011. Reference Source 14. Angus L: The role and functions of CCG medicines optimisation teams. NHS Clinical Commissions, 2021. Reference Source 15. Medicines Management Programme, Preferred Drugs Initiative. Health Service Executive; accessed 19/03/2024. Reference Source 16. Health Service Executive 2022-2025 AMRIC Action Plan. Dublin: Health Service Executive, 2021. Reference Source 17. ATC/DDD Index 2025. WHO, 2025; [29/05/2025]. Reference Source 18. McCarthy C, Flood M, Clyne B, et al. : Medication changes and potentially inappropriate prescribing in older patients with significant polypharmacy. Int J Clin Pharm. 2023; 45 (1): 191–200. PubMed Abstract | Publisher Full Text 19. Summary of PCRS AMRIC GP Green Red Reports 2019/2020 for AMRIC Oversight Group & Antimicrobial Stewardship Advisory Group. 2020. Reference Source 20. Barry M: Guidance on appropriate prescribing of benzodiazepines and z-drugs (BZRA) in the treatment of anxiety and insomnia. Health Service Executive, 2018. 21. Barry M: Appropriate prescribing of opioids in the management of chronic non-cancer pain. Medicines Management Programme (MMP), 2022; 20/09/2022. Reference Source 22. Bleeding and stroke risk from anticoagulant and NSAID. Drug Ther Bull. 2023; 61 (5): 67. Publisher Full Text 23. Dreischulte T, Morales DR, Bell S, et al. : Combined use of nonsteroidal anti-inflammatory drugs with diuretics and/or renin-angiotensin system inhibitors in the community increases the risk of acute kidney injury. Kidney Int. 2015; 88 (2): 396–403. PubMed Abstract | Publisher Full Text 24. McDowell RD, Bennett K, Moriarty F, et al. : Prescriber variation in relation to prescribing trends within the preferred drugs initiative in Ireland (2012-2015): an interrupted time-series study using latent curve models. Med Decis Making. 2019; 39 (3): 278–93. PubMed Abstract | Publisher Full Text 25. Chiedozie C, Murphy ME, Fahey T, et al. : How many medications do doctors in primary care use? An observational study of the DU90% indicator in primary care in England. BMJ Open. 2021; 11 (3): e043049. PubMed Abstract | Publisher Full Text | Free Full Text 26. De Vries T, Henning RH, Hogerzeil HV, et al. : Guide to good prescribing: a practical manual. World Health Organization, 1994. Reference Source 27. Wettermark B, Pehrsson A, Jinnerot D, et al. : Drug utilisation 90% profiles--a useful tool for quality assessment of prescribing in primary health care in Stockholm. Pharmacoepidemiol Drug Saf. 2003; 12 (6): 499–510. PubMed Abstract | Publisher Full Text 28. Malterud K, Siersma VD, Guassora AD: Sample size in qualitative interview studies: guided by information power. Qual Health Res. 2016; 26 (13): 1753–60. PubMed Abstract | Publisher Full Text 29. Nielsen J: Usability engineering. Morgan Kaufmann, 1994. 30. Terry G, Hayfield N, Clarke V, et al. : Thematic analysis. The SAGE handbook of qualitative research in psychology . SAGE Publications Ltd, 2017; 17–36. Publisher Full Text 31. McCarthy C: Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice. Zenodo. 2025. http://www.doi.org/10.5281/zenodo.15632494 Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 18 Jun 2025 ADD YOUR COMMENT Comment Author details Author details 1 Department of General Practice, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin 2, Ireland 2 School of Pharmacy and Biomolecular Sciences, (RCSI) University of Medicine and Health Sciences, Dublin 2, Ireland 3 Department of Public Health & Epidemiology, RCSI, University of Medicine and Health Sciences, Dublin 2, Ireland Caroline McCarthy Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Tom Fahey Roles: Conceptualization, Investigation, Methodology, Writing – Review & Editing Frank Moriarty Roles: Conceptualization, Formal Analysis, Methodology, Writing – Review & Editing Michelle Flood Roles: Conceptualization, Formal Analysis, Methodology, Writing – Review & Editing Eimear Loftus Roles: Investigation, Methodology, Writing – Review & Editing Barbara Clyne Roles: Conceptualization, Formal Analysis, Methodology, Supervision, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information Health Research Board [CSF- 2023-012] The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (1) version 1 Published: 18 Jun 2025, 8:67 https://doi.org/10.12688/hrbopenres.14181.1 Copyright © 2025 McCarthy C et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics VIEWS $counts.viewCount downloads Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article McCarthy C, Fahey T, Moriarty F et al. Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.12688/hrbopenres.14181.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 18 Jun 2025 Views 0 Cite How to cite this report: Vornhagen H. Reviewer Report For: Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.21956/hrbopenres.15596.r48144 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-67/v1#referee-response-48144 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 27 Aug 2025 Heike Vornhagen , University of Galway, Galway, Ireland Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15596.r48144 This article describes the intended qualitative study of a prescribing safety dashboard for GPs in Ireland. It firstly introduces the issue of prescribing safety, before laying out the methodology. Overall I think this will be an interesting study though I ... Continue reading READ ALL This article describes the intended qualitative study of a prescribing safety dashboard for GPs in Ireland. It firstly introduces the issue of prescribing safety, before laying out the methodology. Overall I think this will be an interesting study though I would suggest some minor changes to the protocol, primarily related to readability. First of all, please check spelling (medication related ham :-) ) and some phrases need to be broken up with commas (e.g. If more than 12 volunteer a diverse sample from within this will be selected should be If more than 12 volunteer, a diverse sample from within this will be selected ). Please move this sentence as it is confusing in its current location: 'For metrics displayed as prescribing rates, rates were calculated annually using the total practice population, whereby numbers of private patients were calculated by counting individuals who had at least one encounter in the preceding three years.' I would move this sentence to the explanation given about GMS and private patients as it would follow more logically the first paragraph under 'Setting'. I am also confused as, at the beginning, the authors talk about 'a prescribing safety dashboard' (singular) yet later they talk about 'dashboards' (plural). I presume it is a spelling issue but if not please clarify which other dashboards are meant. And please refer to PPI as 'Proton Pump Inhibitors (PPI) when it is first mentioned. Lastly, I would suggest for the authors to review visualisation good practices (for example Jon Schwabisch or Claus Wilke) as some of the graphs visible on the screenshots are problematic and could be easily improved. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: Data Visualisation, Information System Design, Health Design, Data Dashboards I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Vornhagen H. Reviewer Report For: Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.21956/hrbopenres.15596.r48144 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-67/v1#referee-response-48144 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Steinke D. Reviewer Report For: Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.21956/hrbopenres.15596.r48564 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-67/v1#referee-response-48564 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 26 Aug 2025 Douglas Steinke , The University of Manchester, Manchester, UK Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15596.r48564 This is a well-written article of qualitative research into the usability of a prescribing quality and safety dashboard that is used by GPs in Ireland. The article describes the dashboard well so that the reader can understand what is displayed ... Continue reading READ ALL This is a well-written article of qualitative research into the usability of a prescribing quality and safety dashboard that is used by GPs in Ireland. The article describes the dashboard well so that the reader can understand what is displayed and how it is used. The research questions are clear and given in the article. The methods are well suited to answer the aims of the paper. The methods are described in detail and clear. The results are clearly explained and discussed. There are a couple of questions that I have as reviewer that could be considered by the authors. -Investigating the prescribing metric of "High-risk NSAID prescribing and ACE/ARB and diuretic", could the authors just state that it was not possible to identify OTC NSAID use from the data, unless it could be identified. This would make it clear that data is only prescribed NSAIDs that are available. Could this be a limitation? -Could the authors include a statement that data saturation was obtained in the analysis of transcripts. There were a lot of interviews done and I am sure that data saturation was obtained, but it would be good to confirm it in writing. -Figures 2 and 3 are not readable. It is not easy to read the text in Figure 2 and Figure 3 is incomprehensible in this state. Please consider a different way of producing the figures so that they are readable in the article. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: Health Services Research, programme evaluation, drug utilisation research, pharmacoepidemiology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Steinke D. Reviewer Report For: Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.21956/hrbopenres.15596.r48564 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-67/v1#referee-response-48564 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: O'Callaghan M. Reviewer Report For: Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.21956/hrbopenres.15596.r47950 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-67/v1#referee-response-47950 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 09 Aug 2025 Mike O'Callaghan , University of Limerick, Limerick, Ireland Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15596.r47950 This is an important study that outlines a method for harnessing some of the great volume of prescribing that occurs in general practice in Ireland daily. The "live demo" ("think aloud process") aspect of the participants talking through the screens ... Continue reading READ ALL This is an important study that outlines a method for harnessing some of the great volume of prescribing that occurs in general practice in Ireland daily. The "live demo" ("think aloud process") aspect of the participants talking through the screens that the researchers/software vendor created to analyse prescribing data is particularly interesting. 2 minor points for the authors to consider... 1. I feel the introduction and abstract could be a little bit clearer that the data retrieval and development work has already happened, this only became really clear to me in the "Dashboard Development" section of Methods. Perhaps some of the substantive methods section could be moved to introduction to slim down methods and explain the above a bit more clearly? 2. I'd suggest the authors expand on the Introduction line- "Given that most prescribing occurs in primary care". Open PCRS data shows general practice in 2023 prescribed 95m items on public schemes (GMS 68m, LTI 11m, DPS 16m) alone. I note some more detail is given in Methods-setting section but framing the scale of what happens in general practice is important. With these minor points aside, it's excellent to see this kind of work progressing. It addresses longstanding weaknesses in how Irish GPs currently get feedback on a handful of medicines for GMS patients only, opening up feedback across many other important clinical areas and across patient subgroups (including private patients). The dashboard in Figures 2 & 3 looks very promising. Finally, mention of annual PCS requirements for GPs/doctors to do work analysing their prescribing/practice may increase relevance for working GPs. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: General practice, health informatics, data visualisation I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT O'Callaghan M. Reviewer Report For: Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.21956/hrbopenres.15596.r47950 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-67/v1#referee-response-47950 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 18 Jun 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 Version 1 18 Jun 25 read read read Mike O'Callaghan , University of Limerick, Limerick, Ireland Douglas Steinke , The University of Manchester, Manchester, UK Heike Vornhagen , University of Galway, Galway, Ireland Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Vornhagen H. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 27 Aug 2025 | for Version 1 Heike Vornhagen , University of Galway, Galway, Ireland 0 Views copyright © 2025 Vornhagen H. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This article describes the intended qualitative study of a prescribing safety dashboard for GPs in Ireland. It firstly introduces the issue of prescribing safety, before laying out the methodology. Overall I think this will be an interesting study though I would suggest some minor changes to the protocol, primarily related to readability. First of all, please check spelling (medication related ham :-) ) and some phrases need to be broken up with commas (e.g. If more than 12 volunteer a diverse sample from within this will be selected should be If more than 12 volunteer, a diverse sample from within this will be selected ). Please move this sentence as it is confusing in its current location: 'For metrics displayed as prescribing rates, rates were calculated annually using the total practice population, whereby numbers of private patients were calculated by counting individuals who had at least one encounter in the preceding three years.' I would move this sentence to the explanation given about GMS and private patients as it would follow more logically the first paragraph under 'Setting'. I am also confused as, at the beginning, the authors talk about 'a prescribing safety dashboard' (singular) yet later they talk about 'dashboards' (plural). I presume it is a spelling issue but if not please clarify which other dashboards are meant. And please refer to PPI as 'Proton Pump Inhibitors (PPI) when it is first mentioned. Lastly, I would suggest for the authors to review visualisation good practices (for example Jon Schwabisch or Claus Wilke) as some of the graphs visible on the screenshots are problematic and could be easily improved. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise Data Visualisation, Information System Design, Health Design, Data Dashboards I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Vornhagen H. Peer Review Report For: Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.21956/hrbopenres.15596.r48144) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-67/v1#referee-response-48144 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Steinke D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 26 Aug 2025 | for Version 1 Douglas Steinke , The University of Manchester, Manchester, UK 0 Views copyright © 2025 Steinke D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This is a well-written article of qualitative research into the usability of a prescribing quality and safety dashboard that is used by GPs in Ireland. The article describes the dashboard well so that the reader can understand what is displayed and how it is used. The research questions are clear and given in the article. The methods are well suited to answer the aims of the paper. The methods are described in detail and clear. The results are clearly explained and discussed. There are a couple of questions that I have as reviewer that could be considered by the authors. -Investigating the prescribing metric of "High-risk NSAID prescribing and ACE/ARB and diuretic", could the authors just state that it was not possible to identify OTC NSAID use from the data, unless it could be identified. This would make it clear that data is only prescribed NSAIDs that are available. Could this be a limitation? -Could the authors include a statement that data saturation was obtained in the analysis of transcripts. There were a lot of interviews done and I am sure that data saturation was obtained, but it would be good to confirm it in writing. -Figures 2 and 3 are not readable. It is not easy to read the text in Figure 2 and Figure 3 is incomprehensible in this state. Please consider a different way of producing the figures so that they are readable in the article. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise Health Services Research, programme evaluation, drug utilisation research, pharmacoepidemiology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Steinke D. Peer Review Report For: Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.21956/hrbopenres.15596.r48564) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-67/v1#referee-response-48564 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 O'Callaghan M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 09 Aug 2025 | for Version 1 Mike O'Callaghan , University of Limerick, Limerick, Ireland 0 Views copyright © 2025 O'Callaghan M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This is an important study that outlines a method for harnessing some of the great volume of prescribing that occurs in general practice in Ireland daily. The "live demo" ("think aloud process") aspect of the participants talking through the screens that the researchers/software vendor created to analyse prescribing data is particularly interesting. 2 minor points for the authors to consider... 1. I feel the introduction and abstract could be a little bit clearer that the data retrieval and development work has already happened, this only became really clear to me in the "Dashboard Development" section of Methods. Perhaps some of the substantive methods section could be moved to introduction to slim down methods and explain the above a bit more clearly? 2. I'd suggest the authors expand on the Introduction line- "Given that most prescribing occurs in primary care". Open PCRS data shows general practice in 2023 prescribed 95m items on public schemes (GMS 68m, LTI 11m, DPS 16m) alone. I note some more detail is given in Methods-setting section but framing the scale of what happens in general practice is important. With these minor points aside, it's excellent to see this kind of work progressing. It addresses longstanding weaknesses in how Irish GPs currently get feedback on a handful of medicines for GMS patients only, opening up feedback across many other important clinical areas and across patient subgroups (including private patients). The dashboard in Figures 2 & 3 looks very promising. Finally, mention of annual PCS requirements for GPs/doctors to do work analysing their prescribing/practice may increase relevance for working GPs. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise General practice, health informatics, data visualisation I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) O'Callaghan M. Peer Review Report For: Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study [version 1; peer review: 3 approved] . HRB Open Res 2025, 8 :67 ( https://doi.org/10.21956/hrbopenres.15596.r47950) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-67/v1#referee-response-47950 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. 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