| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
ORIGINAL ARTICLE |
1 GKT Concordance Unit, Department of General Practice and Primary Care, Guy’s King’s and St Thomas’ School of Medicine, King’s College London
2 Department of Practice and Policy, The School of Pharmacy, University of London
3 Department of General Practice, University College, Cork
Correspondence to:
Professor N Britten, Institute of Clinical Education, Peninsula Medical School, Universities of Plymouth and Exeter, St Luke’s Campus, Exeter, Devon EX1 2LU, UK;
nicky.britten{at}pms.ac.uk
Objective: To explore the feasibility of using a broader definition of the appropriateness of prescribing in general practice by developing ways of measuring this broader definition and by identifying possible relationships between different aspects of appropriateness and patient outcomes.
Design: A questionnaire study of patients and general practitioners before and after study consultations, supplemented by data collected from patients’ medical records and telephone interviews with patients 1 week later.
Setting: General practices in the south of England.
Participants: 24 general practitioners and 186 of their consulting patients.
Main outcome measures: Unwanted, unnecessary, and pharmacologically inappropriate prescriptions; patients’ adherence.
Results: Before the consultation 42% of patients said they wanted or expected a prescription for their main problem. Prescriptions were written in two thirds (65%) of study consultations, and 7% of these had not been wanted or expected beforehand. Doctors recorded that one in five prescriptions they wrote were not strictly indicated. Of the 92 independent assessments of these prescriptions, four were judged to be inappropriate and in 19 cases the assessors were uncertain. 41% of prescriptions written were wanted, necessary, and appropriate. Subsequently, 18% of patients for whom a prescription had been written were potentially non-adherent and 25% had worries or concerns about their medication.
Conclusion: The attempt to measure appropriateness of prescribing along the three dimensions of patients’, prescribers’, and pharmacological perspectives is both feasible and likely to yield valuable insights into the nature of general practice prescribing and patients’ use of medicines.
Keywords: general practice; patient-caregiver relationship; prescribing
This article has been cited by other articles:
|
|
 |
|
  S. Latter, J. Maben, M. Myall, and A. Young Evaluating the clinical appropriateness of nurses' prescribing practice: method development and findings from an expert panel analysis Qual. Saf. Health Care, December 1, 2007; 16(6): 415 - 421. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Bromley Clinicians' Concepts of the Cognitive Deficits of Schizophrenia Schizophr Bull, May 1, 2007; 33(3): 648 - 651. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Hamilton, D. Russell, C. Stabb, D. Seamark, C. Campion-Smith, and N. Britten The effect of patient self-completion agenda forms on prescribing and adherence in general practice: a randomized controlled trial Fam. Pract., February 1, 2007; 24(1): 77 - 83. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Latter, J. Maben, M. Myall, A. Young, and A. Baileff Evaluating prescribing competencies and standards used in nurse independent prescribers' prescribing consultations: An observation study of practice in England Journal of Research in Nursing, January 1, 2007; 12(1): 7 - 26. [Abstract] [PDF]
|
|
|
|
 |
|
 M. P. Tully and J. A. Cantrill The validity of explicit indicators of prescribing appropriateness Int. J. Qual. Health Care, April 1, 2006; 18(2): 87 - 94. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Britten Patients' expectations of consultations BMJ, February 21, 2004; 328(7437): 416 - 417. [Full Text] [PDF]
|
|
|
|
|
|
G Elwyn and J Braspenning "Doing prescribing": high hopes and unexplored beliefs Qual. Saf. Health Care, August 1, 2003; 12(4): 243 - 243. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
