Last review date 22/05/2023

The following gives information about tools within Ardens that can be used to demonstrate work in the relevant clinical areas, helping to illustrate the level of safe and effective clinical care you are providing.



1. Monitoring of DMARDs


The monitoring of patients taking DMARDs is one of the CQC's key lines of enquiry (KLOE). They are likely to focus on the monitoring for Methotrexate, Azathioprine and Leflunomide. We have searches that cover the monitoring of all of these in addition to the other DMARDs, these can be found in - Clinical Reporting > Ardens > Prescribing > Monitoring | DMARDS



In addition to our monitoring reports, we have alert reports which can highlight patients whose blood test results suggest the patient needs additional monitoring or a referral back to a specialist for review. These can be found in Clinical Reporting > Ardens > Prescribing > Alerts | DMARDS



2. High risk drug monitoring


In addition to reviewing the monitoring of DMARDs, the CQC will also look at the monitoring of other high risk medications, including the following medications. These medications are covered by our monitoring reports which can be found in the locations listed below:

  • Lithium - Clinical Reporting > Ardens > Prescribing > Monitoring | Mental Health 
  • Spironolactone and eplerenone - Clinical Reporting > Ardens > Prescribing > Monitoring | Cardiovascular
  • ACE inhibitor or ARB - Clinical Reporting > Ardens > Prescribing > Monitoring | Cardiovascular
  • Amiodarone - Clinical Reporting > Ardens > Prescribing > Monitoring | Cardiovascular
  • Warfarin - Clinical Reporting > Ardens > Prescribing > Monitoring | Anticoagulants
  • DOAC - Clinical Reporting > Ardens > Prescribing > Monitoring | Anticoagulants
  • Mirabegron - Clinical Reporting > Ardens > Prescribing > Monitoring | Genitourinary


In addition to these monitoring reports, we have alert reports which highlight patients whose blood test results suggest the patient needs additional monitoring or a referral back to a specialist for review. These can be found in Clinical Reporting > Ardens > Prescribing > Alerts


Specific drug monitoring templates can also be used as part of routine practice when reviewing patients and completing their monitoring.



All of the drug monitoring reports will be inherently run as part of the Drug Monitoring invitation system.


The Prescribing searches can easily be viewed as a dashboard and allocated to team members to action using Ardens Manager.


3. MHRA/CAS/drug safety update alerts 


As new MHRA/CAS alerts are released we will write reports and update our "Alerts & Updates" as appropriate. The reports can be found in Clinical Reporting > Ardens Ltd > Alerts | Other > CAS Alerts. 


MHRA/CAS alerts that have a lasting impact on prescribing will go on to be included in our Prescribing | Alert or Prescribing | Monitoring folder under the relevant clinical area.  For the areas CQC will likely focus on we have reports in the following locations:

  • Valproate - Clinical Reporting > Ardens > Prescribing > Alerts | Women's Health
  • Epipens - Clinical Reporting > Ardens > Prescribing > Alerts | Allergies
  • Carbimazole - Clinical Reporting > Ardens > Prescribing > Alerts | Pregnancy
  • Citalopram - Clinical Reporting > Ardens > Prescribing > Alerts | Mental Health
  • Clopidogrel and omeprazole - Clinical Reporting > Ardens > Prescribing > Alerts | Antiplatelets
  • Simvastatin and amlodipine - Clinical Reporting > Ardens > Prescribing > Alerts | Cardiodiovascular
  • ACE and ARB - Clinical Reporting > Ardens > Prescribing > Alerts | Cardiovascular


4. Potential missed diagnosis of diabetes


Another KLOE for the CQC is potential missed diabetes diagnosis. We have a number of case finder reports which can be used to identify patients who potentially have diabetes based on their previous HbA1c results, medication prescribed or previous coding. These reports can be found in Clinical Reporting > Ardens > Conditions | Diabetes > Case finders



5. Medicines usage


The CQC will also look at the usage of certain medications, we have reports that cover all of these areas which can be found in the following locations. 

  • Number of asthmatic patients issued more than 12 SABA inhalers in the last 12 month - Clinical Reporting > Ardens > Conditions | Respiratory > Alerts
  • The prescribing of gabapentinoid medicines where review is indicated - Clinical Reporting > Ardens > Prescribing > Alerts | Neurology
  • The prescribing of benzodiazepine and ‘Z’ drugs where the frequency of issue warrants investigation - Clinical Reporting > Ardens > Prescribing > Alerts | Benzodiazepine and Z drugs


This support article gives further information on the specific CQC searches.

Please contact our Medicines team if you have any further questions medicines-systmone@ardens.org.uk