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Eur J Clin Pharmacol (2005) 61: 127133
DOI 10.1007/s00228-004-0876-3PHARMACOEPIDEMIOLOGY AND PRESCRIPTIOND. Williams K. Bennett J. FeelyThe application of prescribing indicators to a primary care prescription
database in IrelandReceived: 7 May 2004 / Accepted: 23 November 2004 / Published online: 12 February 2005
Springer-Verlag 2005Abstract Objective: To develop appropriate prescribing
indicators and apply these to Irish prescription data.
Methods: A postal survey of 145 randomly selected
general practitioners working within the Eastern Health
Board region of the State-supported General Medical
Services scheme in Ireland regarding the applicability of
selected prescribing indicators was carried out. Such
indicators were then applied to aggregate prescription
data.Results: Prescribing indicators based on agents of
questionable ecacy/poor quality prescribing and those
based on good prescribing practice were thought to
make suitable indicators. Low rates of prescribing were
noted for indicators based on drugs of limited ecacy,
e.g. cerebral and peripheral vasodilators (rate 3.1 per
1,000 prescriptions), whilst indicators based on drugs
associated with good prescribing practice were associated with higher prescribing rates, e.g. the prescription
of aspirin in patients receiving nitrate therapy(rate 7.13
per 1,000 patients). However, a low rate of generic
prescribing (4.6%) was found amongst general practitioners in the study. The largest variability in prescribing
was seen with the prescribing of peripheral and cerebral
vasodilators (75th/25th centile=5.6) and the prescription of long-acting sulphonylureas (75th/25th centile=66.6).Conclusions: Quality indicators based on aggregate prescribing provide valuable information on prescribing
standards and should be developed with the close
involvement of prescribers.IntroductionRecognising good prescribing is an important issue both
in terms of the quality of care provided to patients and
the potential costs associated with poor prescribing.
While it is impractical to study each doctors prescribing
in detail, prescribing performance may be analysed by
proxy measures. Indicators of the appropriateness of
prescribing have a central place in evaluating the performance of prescribers and encouraging improvements
in the quality of care. A quality indicator has been de-
ned by the European working party on quality in primary care as a measurable element of practice
performance for which there is evidence or consensus
that it can be used to assess quality and hence change in
the quality of care provided [1].With the advent of
clinical guidelines, a clear view of prescribing standards
to be attained and valid...