Hugh McGavock sadly died on the 17th April 2018 aged 79 years. True to form, at the time of his death, he was in the midst of planning a new medical school with the University of Ulster.
Professor Hugh McGavock, a general practitioner by background, was a protégé of Professor Owen Wade from Queen’s University, Belfast. Professor McGavock was the head of the Drug Utilisation Research Unit at Queens University, Belfast before becoming a Professor at the University of Ulster.
Professor Hugh McGavock was a founder member of DURG UK & Ireland (Drug Utilisation Research Group – now known as PRIMM UK & Ireland). Amongst his other professional activities throughout his long and distinguished career, he:
- was a member of the Committee on the Safety of Medicines for the UK.
- advised the governments/medical associations of Australia, South Africa, Ireland, Portugal, Czech Republic, Sweden, Germany and Republic of Ireland.
- led the team at Queen’s University, Belfast who developed and delivered an academic detailing system for Northern Ireland (called COMPASS) which was the forerunner of PACT (prescription analysis and cost tabulation) in the UK.
- was part of the group convened by Professor Marshall Marinker that reviewed the literature on compliance that ultimately produced the concordance concept (he edited the section on the quantitative literature).
- edited the 1st edition of the Drug Utilisation Research Handbook produced by DURG UK & Ireland. He also wrote a book on clinical pharmacology (How drugs work: Basic pharmacology for healthcare professionals).
- published extensively, including a seminal paper in the BMJ on how new drugs were taken up in the NHS. (McGavock H, Webb CH, Johnston GD, Milligan E. Market penetration of new drugs in one United Kingdom region: implications for general practitioners and administrators. BMJ. 1993 Oct 30; 307 (6912):1118-20).
- edited four editions of the Practice Formulary of the Royal College of General Practitioners.
- was Provost of the Royal College of General Practitioners (Northern Ireland Faculty) and an honorary fellow of the Royal College of General Practitioners.
- put 105 GPs (in Northern Ireland) through the Certificate in Prescribing Science. (It is a testament to Professor McGavock’s dedication to developing young talents that he viewed this as the most rewarding work of his career).
- organised international meetings on drug utilisation research held in Oxford town hall in 1993 and University of Ulster in 2005. The Oxford meeting was attended by 345 drug utilisation researchers from six continents and ultimately led to the establishment of EURODURG in 1995.
- was the founding Chairman of EURODURG in 1995/6.
- was a major driver of DURG UK & Ireland in its early years, and his influence lives on through the bursary which he created.
Hugh is fondly remembered by PRIMM committee members as an inspirational figure. Professor Janet Krska (Medway School of Pharmacy) recalls when, as a formulary pharmacist in Aberdeen, “Hugh gave me a copy of the Northern Ireland formulary (which I only recently threw away) and sent me copies of his feedback material which he used to encourage prescribing within it, as I was also providing feedback to prescribers at the time”. She also recalls that he classified medicines into three types: symptomatic, presumptive and specific and advocated ‘Precision Prescribing’, which he described as: “What you would advise if you were treating your own family and paying the drug yourself”. She still has a copy of a 1995 report which Hugh drafted in which he espoused five commandments:
- Avoid drugs for which claims are not well supported by independent evidence
- Avoid drugs which are ineffectual
- Avoid therapeutic sledgehammers except when the indication is absolute
- Avoid economic irrationality
- Avoid drugs with poor risk-benefit ratios
Nothing has changed – the advice is still as good as it was then!
Professor Philip Routledge (Cardiff University) recalls a lecture Hugh gave in Ireland that stimulated him to set up the MSc in Primary Care Therapeutics at Cardiff University more than 25 years ago.
Professor Colin Bradley recalls meeting Hugh in Belfast and being shown (with unbounding enthusiasm) the COMPASS system Hugh had devised. Hugh was also implementing ideas from the US about academic detailing that ultimately led to the initiation of prescribing advisers to what were then Family Health Services Authorities.
On a personal level Hugh was a very warm and gregarious individual, although he was also capable of the kind of straight talking for which his Northern Irish countrymen are known. He was the sort of person who would meet conference delegates on arrival and carry their suitcase up to their room.
Hugh was very keen to encourage and support more junior drug utilisation researchers in their careers, hence the “Hugh McGavock award” for the best abstract submitted for presentation at the PRIMM annual scientific meeting.
Winners of the bursary include:
- 2006: Sean Macbride-Stewart, “The effect of quality incentives in general practice: observations on prescribing patterns using the Defined Daily Dose method”.
- 2007: Dr Rachel Howard, “Design specification for NHS IT systems to minimise risk of harm to patients from medications”.
- 2008: Dr Cristin Ryan, “Screening tools for elderly patients in primary care”.
- 2009: Dr Mark Connell, “Implementation of national dyspepsia guidelines to reduce prescribing and return patients to self care: Results from an educational intervention and prospective clinical audit in England”.
- 2010: Dr Tamasine Grimes, “Medication reconciliation on discharge from acute hospital care in Ireland”.
- 2011 Dr Asam Latif, “Exploring community pharmacy Medicines Use Reviews as a means of improving the clinical and cost effectiveness of prescribed medicines and reducing waste”.
- 2012: Dr Richard Keers, “Systematic review of direct observation evidence investigating the prevalence and nature of medication administration errors”.
- 2013: Dr Bernadette Flood, “Multiple-medication use in people ageing with intellectual disability (PAWID) and behaviour disorders – Polypharmacy not superior Quality Indicator”.
- 2014: Dr Richard Keers, “A prospective study investigating the frequency and nature of prescribing errors in mental health hospitals and which factors predict their occurrence”.
- 2015: Dr Lucy Moore, “How patients optimise medicines in everyday life”.
- 2016: Dr Wasim Baqir, “Evaluating models of medicines optimisation in care homes”.
- 2017: Dr Shane Cullinan, “Application of a frailty index threshold to identify older patients at risk of potentially inappropriate prescribing and adverse drug reactions: a prospective observational study”.
- January 2018: Professor Janet Krska, ” Factors affecting perceptions of medicine burden – how does age contribute?”