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.

The effects of haloperidol on visual search, eye movements and psychomotor performance.

The effects of single doses of haloperidol (2, 4 and 6 mg) were compared with lorazepam 2.5 mg and placebo in 15 healthy subjects. Visual search strategy was measured, along with a range of psychomotor and eye movement tests.

How has fundholding in Northern Ireland affected prescribing patterns? A longitudinal study.

Objective: To compare prescribing patterns in general practices before and after the introduction of fundholding in April 1993 to determine whether fundholding changed prescribing patterns among practices that joined the scheme.

Design: Analysis of prescribing data from the Drug Utilisation Research Unit's database for all practices in Northern Ireland during April 1989 to March 1996.

Setting: Northern Ireland.

Predicting prescribing costs in general practice using practice demography.

Prescription and dispensing costs form a large part (c. 56%) of primary care expenditure in the NHS and concern has been expressed at its ever increasing total. Previous predictive models have either failed to account for a high proportion of costs or else have not been able to explain adequately the role practice list demography plays upon costs.

Temporal trends in drug use in one UK region, revealed by chemical group matching.

(1) The pharmaceutical pricing data for Northern Ireland were amended to include defined daily dosages (DDD) for all single chemical entities. Eight therapeutic groups were studied: antiasthmatics, antidepressants, antimicrobials, benzodiazepines, hormone replacement therapy (HRT), hypoglycaemics, lipid-lowering agents and ulcer-healing drugs. Each group was then subdivided into its main chemical groups.

Formulary revision: eliciting the opinions of users.

Background: Few peer-reviewed reports have been published that document the extent and type of use of published formularies in general practice. As publishers of the Practice Formulary of the Royal College of General Practitioners, the Northern Ireland Faculty Board commissioned a large-scale survey to quantify these issues, for the purpose of improving the revision process.

Aim: The aim of the survey was to investigate the extent to which general practitioners in Northern Ireland use the Practice Formulary and the ways in which they use it, and to elicit their opinions on ways in which it could be improved.

A 'compass' for general practitioner prescribers.

This paper records the result of research and development in interrogating a general practitioner prescription pricing database to provide customised analysis for every practice. The system 'COMPASS' (Computerised On-line Monthly Prescribing Analysed for Science and Stewardship) is described, and identifies instances where each practice might improve cost-effectiveness and scientific rationality in prescribing. One hundred and two such instances are interrogated.

Relationship between the number of partners in a general practice and the number of different drugs prescribed by that practice.

The objective of this study was to assess whether practice size, as measured by the number of doctors, had any bearing on the range of drugs prescribed. All practices in the northern and western health boards in Northern Ireland were included in the study--a total of 132 practices (362 doctors) serving a population of 628,249. Prescribing data, obtained from the Department of Health and Social Services (Northern Ireland) information technology unit database, were analysed retrospectively for the month of January 1989.

Smoking among schoolchildren.

As part of its health education programme, the Irish Cancer Society sponsored studies of the smoking habits of Dublin schoolchildren in the late 1960s and early 1970s. It was decided to review the situation a decade later, and accordingly the Health Education Bureau, the Medico-Social Research Board and the Irish Cancer Society funded a survey of smokers among Dublin post-primary schoolchildren in 1981.The prevalance of smoking among schoolchildren is still at a high level, and the main change over the last 10 years has been the fact that girls have almost caught up with the boys.