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. Responses to 26 of these questions were used to score the quality of management. The subjects were a random sample of 57 practices stratified for number of partners, geographical area, and fundholding status.

Results: The main outcome measures were the percentage adoption of recommended procedures at the time of repeat prescription issue and at the review consultation, use of computing for repeat prescribing and the effects of fundholding; and quality assurance scores. During issue of repeats, essential checks are often omitted; the potential of computerization for improving management is often not realized. At review consultation, the opportunities for quality assurance are often missed. Fundholders manage repeat prescribing significantly better than non-fundholders, but in neither group is the mean management score exemplary.

Conclusion: We have identified and quantified serious deficiencies in repeat prescribing management in a representative sample large enough to permit extrapolation to the regional population of GPs. In response, we have devised guidelines that GPs might use to address this problem. We have tested and proved a scoring system for repeat prescribing evaluation.