Background: Differences in prescribing behaviour among general practitioners (GPs).
Aim: To formulate and validate clinical prescribing indicators based on general practice guidelines.
Design: Validatory study.
Setting: Pharmacies and general practices in the Netherlands in 2003.
Participants: A total of 379 pharmacies, 947 general practices and 3.8 million patients.
Methods: A total of 51 potential indicators were formulated, based on medicinal recommendations from the evidence-based guidelines of the Dutch College of General Practitioners and the corresponding recommendations from the Commission Pharmaceutical Help of the Health Care Insurance Board. These indicators were submitted to an expert panel to assess content validity. The panel assessment was analysed using the RAND-UCLA appropriateness method (RAM). Then, for the remaining indicators, it was assessed to what extent these could be used to determine the prescribing behaviour of GPs and the level to which this behaviour varies among GPs. This was done using a prescribing analyses and cost (PACT) database that was compiled from prescription databases from 379 pharmacies, with all prescriptions from 1,434 GPs over an entire year to 3.8 million patients.
Results: The panel considered 34 of the 51 potential indicators to be valid with respect to providing an adequate reflection of the central recommendations in the guideline and in terms of relevance with respect to health gain and/or efficiency. Of these 34 indicators, 20 revealed considerable differences in the prescribing behaviour of GPs.
Conclusion: On the basis of existing general practice guidelines, 20 prescribing indicators could be formulated that were assessed by an expert panel to be sufficiently valid and which could also discriminate the prescribing behaviour of GPs as reflected in the prescription databases of pharmacies.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00228-004-0821-5 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Findings from an expert focus group on psychotropic medication deprescribing practices for children and youth with complex needs.
Front Child Adolesc Psychiatry
November 2024
Applied Research & Evaluation, Child and Parent Resource Institute, Ministry of Children, Community and Social Services, London, ON, Canada.
Introduction: Psychotropic medication can be effective at stabilizing emotional and behavioural disturbances associated with physiological processes in children and youth. When medication benefits, indication or adverse effects are queried, deprescribing should be considered. Current guidelines for deprescribing are mainly for adults/elderly and largely theoretical, not practical, especially for polypharmacy.
View Article and Find Full Text PDFBackground: Clinicians need to prescribe antibiotics in a way that adequately treats infections, while simultaneously limiting the development of antibiotic resistance (ABR). Although there are abundant guidelines on how to best treat infections, there is less understanding of how treatment durations and antibiotic types influence the development of ABR. This study adopts a self-controlled case study (SCCS) method to relate antibiotic exposure time to subsequent changes in resistance patterns.
View Article and Find Full Text PDFA retrospective review of the common childhood illnesses and the indications for antibiotic prescription at community hospital in Malawi.
Front Antibiot
September 2024
Research and Education, Clinical Research Education and Management Services (CREAMS), Lilongwe, Malawi.
Background: Childhood remains a vulnerable period and a key determiner for adult health. Various illnesses experienced by children in their early years determine future performance and contribution to society. Acute and chronic infectious diseases, undernutrition, and early childhood non-communicable diseases have greatly been linked to intellectual disability, poor childhood development, increased morbidity, and household and healthcare economic costs.
View Article and Find Full Text PDFReducing medical cannabis use risk among Veterans: A descriptive study.
Harm Reduct J
January 2025
Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada.
Background: Canadian Veterans experiencing chronic pain report concerns about accessing accurate information on the risks associated with medical cannabis (MC) use. The Lower Risk Cannabis Use Guidelines (LRCUG) were developed to equip individuals who use cannabis recreationally with safer-use strategies. Many of the harm reduction recommendations for recreational cannabis use are relevant and important considerations for MC use.
View Article and Find Full Text PDFLongitudinal Treatment Patterns of Chorea in North American Patients with Huntington's Disease: Data from Enroll-HD.
Neurol Ther
January 2025
Health Economics and Outcomes Research, Neurocrine Biosciences, Inc., 12780 El Camino Real, San Diego, CA, 92130, USA.
Introduction: Chorea is the primary manifestation of Huntington's disease. Different clinicians pursue varied approaches to chorea management, and real-world evidence describing them is needed. The objective of this study was to assess the presence and severity of chorea, chorea pharmacotherapy, and treatment practice, and patterns in a large natural-history cohort with Huntington's disease.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!