Characteristics of GPs responding to an educational intervention to minimise inappropriate prescriptions: subgroup analyses of the Rx-PAD study.

Background: Interventions aimed at improving GPs' prescribing practice usually apply a 'one size fits all' when analysing intervention effects. Few studies explore intervention effects by variables related to the GPs' age, sex, specialist status, practice type (single-handed versus group), practice setting (urban versus rural), and baseline performance regarding the target of an intervention.

Aim: To explore the characteristics of the GPs responding to a comprehensive educational intervention.

Potentially Inappropriate Prescribing to Older Patients: Criteria, Prevalence and an Intervention to Reduce It: The Prescription Peer Academic Detailing (Rx-PAD) Study - A Cluster-Randomized, Educational Intervention in Norwegian General Practice.

Potentially inappropriate prescriptions (PIP) is drug treatment, which in general, at the group level for a median/mean patient, can be considered unfavourable meaning that the risks commonly may outweigh the benefits. This MiniReview reports and discusses the main findings in a large cluster-randomized educational intervention in Norwegian general practice, aimed at reducing the prevalence of PIPs to patients ≥70 years (The Rx-PAD study). Targets for the intervention were general practitioners (GPs) in continuing medical education (CME) groups receiving educational outreach visits (i.

Prescription peer academic detailing to reduce inappropriate prescribing for older patients: a cluster randomised controlled trial.

Background: Older patients are at particular risk for adverse drug reactions. In older people, interventions targeting potentially inappropriate prescriptions (PIPs) are considered important measures to minimise drug-related harm, especially in the general practice setting where most prescriptions for older patients are issued.

Aim: To study the effects of a multifaceted educational intervention on GPs' PIPs for older patients.

Changed terms for drug payment influenced GPs' diagnoses and prescribing practice for inhaled corticosteroids.

Background: Inhaled glucocorticosteroids (ICS) are first-line anti-inflammatory treatment in asthma, but not in chronic obstructive pulmonary disease (COPD). To restrict ICS use in COPD to cases of severe disease, new terms for reimbursement of drug costs were introduced in Norway in 2006, requiring a diagnosis of COPD to be verified by spirometry.

Objectives: To describe how GPs' diagnoses and treatment of patients who used ICS before 2006 changed after a reassessment of the patients that included spirometry.

The Norwegian General Practice (NORGEP) criteria for assessing potentially inappropriate prescriptions to elderly patients. A modified Delphi study.

Objective: To establish a clinically relevant list with explicit criteria for pharmacologically inappropriate prescriptions in general practice for elderly people > or =70 years.

Design: A three-round Delphi process for validating the clinical relevance of suggested criteria (n = 37) for inappropriate prescriptions to elderly patients.

Setting: A postal consensus process undertaken by a panel of specialists in general practice, clinical pharmacology, and geriatrics.

Pharmacologically inappropriate prescriptions for elderly patients in general practice: How common? Baseline data from The Prescription Peer Academic Detailing (Rx-PAD) study.

Objective: To assess Norwegian general practitioners' (GPs') level of potentially harmful drug prescribing for elderly patients.

Design: Prescription data for 12 months were retrospectively retrieved from the Norwegian Prescription Database (NorPD). Data were assessed in relation to 13 prescription quality indicators.

[Healthcare providers' experience with multi-dose packaged medicines].

Background: To prevent medication errors, community homecare services (CHS) increasingly use multi-dose packaged medicines (MDPM) for their clients. More knowledge is needed on how MDPM affects routines and quality of medication handling in the CHS.

Material And Methods: Four CHS districts in a Norwegian community (27 GPs, 121 nurses) participated in the study.

Can antibiotic prescriptions in respiratory tract infections be improved? A cluster-randomized educational intervention in general practice--the Prescription Peer Academic Detailing (Rx-PAD) Study [NCT00272155].

Background: More than half of all antibiotic prescriptions in general practice are issued for respiratory tract infections (RTIs), despite convincing evidence that many of these infections are caused by viruses. Frequent misuse of antimicrobial agents is of great global health concern, as we face an emerging worldwide threat of bacterial antibiotic resistance. There is an increasing need to identify determinants and patterns of antibiotic prescribing, in order to identify where clinical practice can be improved.

A cluster-randomized educational intervention to reduce inappropriate prescription patterns for elderly patients in general practice--The Prescription Peer Academic Detailing (Rx-PAD) study [NCT00281450].

Background: Age-related alterations in metabolism and excretion of medications increase the risk of adverse drug events in the elderly. Inappropriate polypharmacy and prescription practice entails increased burdens of impaired quality of life and drug related morbidity and mortality. The main objective of this trial is to evaluate effects of a tailored educational intervention towards general practitioners (GPs) aimed at supporting the implementation of a safer drug prescribing practice for elderly patients > or = 70 years.

[The withdrawal of Vioxx: how did the patients react?].

Background: The withdrawal of rofecoxib (Vioxx) from the global market because of adverse cardiovascular effects affected many patients and created a lot of publicity.

Material And Methods: 287 patients from four general practices who had received prescriptions for rofecoxib in 2004 were identified from the medical records of their general practitioner (GP) and mailed a questionnaire addressing their reactions and their expectations of their GP in this respect.

Results: 140 out of 287 patients returned the questionnaire.

[Do general practitioners know what medication community nurses give their shared patients?].

Background: Frail elderly outpatients often receive medicines from community nurses. There is little knowledge of how general practitioners (GPs) and nurses update and coordinate their medication lists for their shared patients.

Material And Methods: Lists of regular medication for 90 randomly selected shared patients from GPs as well as community nurses were assessed with respect to agreement.