Peripheral vasodilators and the management of peripheral vascular disease and Raynaud's syndrome in general practice.

There is no convincing evidence that peripheral vasodilators produce any significant improvement in exercise tolerance in patients with peripheral vascular disease, and these drugs may do more harm than good. In the treatment of severe Raynaud's syndrome, however, thymoxamine, prazosin or nifedipine is recommended. A descriptive study was carried out, firstly, to determine why these drugs are prescribed in general practice, and secondly, to describe the drug choices in the treatment of both Raynaud's syndrome and peripheral vascular disease in a representative sample of 22 practices in Northern Ireland.

Research methodology: Coding perceived morbidity in general practice--an evaluation of the Read Classification and the International Classification of Primary Care (ICPC).

Objectives: To evaluate the Read Classification and the International Classification of Primary Care (ICPC).

Methods: The Read Classification was used to code the diagnoses for 3474 patient encounters, in a pilot sample of three volunteer practices (11 general practitioners), and the ICPC was used to code 21,416 patient encounters in a stratified quota sample of 22 practices (59 general practitioners), in a survey aiming to relate prescribing to perceived diagnosis. RESULTS/EXPERIENCE: The Read Classification was found to be a detailed and exhaustive classification of medical diagnoses, but it was more time consuming to use than the ICPC, due to the complexity of the classification, the over-use of alpha characters compared to the ICPC, and the mixing of alpha characters with numeric digits within the codes.

Motherhood in the teens and twenties: some surprises.

We report a study of the association of health and social support variables with motherhood in teenagers and older mothers. Both teenage and older mothers reported poorer physical and mental health and fewer and less frequent social contacts than their nulliparous peers. Contrary to expectation, however, older mothers reported less extensive and less adequate social support networks than did teenagers.

Repeat prescribing management--a cause for concern?

Background: No existing studies of repeat prescribing management have been carried out on statistically adequate samples permitting an extrapolation of results with regard to the population of general practitioners (GPs).

Aim: To provide adequate regional evidence of the quality of repeat prescribing management for the profession and its administrators, and to test a scoring system for quality assurance in repeat prescribing practice.

Method: A semi-structured questionnaire was administered by one observer to a statistically representative population sample of Northern Ireland's general practices to investigate the extent to which they adopted recommended procedures for the management of repeat prescribing.