Uppsala University, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala, Sweden.
Ups J Med Sci. 2012 Nov;117(4):439-44. doi: 10.3109/03009734.2012.713038. Epub 2012 Aug 30.
General practice accounts for the vast majority of drug prescribing in the Nordic countries. Various methods have been used to promote rational drug prescribing. Awareness of own prescribing profile may be a first crucial step in the quality assessment and improvement process.
To analyse awareness among general practitioners of their drug prescribing profile during two outreach visits one year apart.
All 94 practices with a total of 166 general practitioners in the former Storstrøm County, Denmark, were invited to participate in a project launching outreach visits led by a general practitioner; 88 practices with 160 general practitioners agreed to participate.
During the first round of outreach visits the general practitioners were asked to rate their own prescribing level of 13 major drug groups as being in the lowest 25%, the middle 26%-74%, or the highest 25% of the distribution across all 88 practices. The result was better than chance (chi-square = 337, 4 df, r = 0.37, both P < 0.0001). After the assessment a one-hour discussion on rational drug prescribing was held. One year later a new round of outreach visits was held. This time the assessment accuracy was generally greatly improved (chi-square = 724, 4 df, r = 0.48, both P < 0.0001). The main determinants for the improved accuracy during the second round were high accuracy during the first round, and the number of general practitioners in the practice.
General practitioners' awareness of their prescribing volumes was substantially improved by a single outreach visit with discussion on rational drug prescribing.
全科医生负责北欧国家绝大多数的药物处方。已经使用了各种方法来促进合理用药。了解自己的处方概况可能是质量评估和改进过程中的第一步。
分析相隔一年的两次外展访问中,全科医生对其药物处方概况的认识。
丹麦前 Storstrøm 县的所有 94 个有 166 名全科医生的实践都被邀请参加由一名全科医生领导的外展访问项目;88 个实践中有 160 名全科医生同意参加。
在第一轮外展访问中,要求全科医生将自己的 13 种主要药物的处方水平评为分布在所有 88 个实践中的最低 25%、中间 26%-74%或最高 25%。结果好于机会(卡方=337,4df,r=0.37,均 P<0.0001)。评估后,进行了一个小时关于合理用药的讨论。一年后,进行了新一轮的外展访问。这次评估的准确性普遍大大提高(卡方=724,4df,r=0.48,均 P<0.0001)。第二轮准确性提高的主要决定因素是第一轮准确性高,以及实践中的全科医生人数。
单次外展访问加上关于合理用药的讨论,大大提高了全科医生对其处方量的认识。