English, Article edition: Pharmacotherapeutic Circles: Results of an 18-Month Peer-Review Prescribing-Improvement Programme for General Practitioners Liselotte von Ferber; Jurgen Bausch; Ingrid Koster; ...

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Physical Description
  • article
Language
  • English

Edition details

Title
  • Pharmacotherapeutic Circles: Results of an 18-Month Peer-Review Prescribing-Improvement Programme for General Practitioners
Author
  • Liselotte von Ferber
  • Jurgen Bausch
  • Ingrid Koster
  • Ingrid Schubert
  • Peter Ihle
Physical Description
  • article
Notes
  • Objective: To assess the effectiveness of the pharmacotherapeutic circle (PTC), a general practitioner (GP) prescribing-improvement programme to enhance prescribing quality and reduce drug costs. Design: Combined pre- and post-intervention time-series design using an internal comparison of subgroups and an external comparative control. Setting: Small discussion groups meeting 8 times over 18 months. Participants: 79 GPs exceeding the mean drug costs/​patient of all Hessian physicians by >=​40%; 10 moderators. Interventions: Peer-review feedback of prescription patterns based on guidelines targeting 3 suboptimal prescribing areas: drug prescriptions lacking evidence-based efficacy (target A); presumptive prescribing habits (target B); and underprescribing of new, effective therapies (target C). Main outcome measures and results: Significant decreases in prescription rates for target A drugs were recorded for varicose vein medications (p =​ 0.006), peripheral vasodilators (p =​ 0.0001) and topical antirheumatics (p =​ 0.0145), but not for prokinetics/​enzymes/​digestives. Prescribing of target B drugs such as benzodiazepines and nonsteroidal anti-inflammatory drugs declined markedly (p =​ 0.0019 and 0.0014, respectively). Target C drug prescriptions such as for opioids and proton pump inhibitors were not significantly increased. Highly significant reductions in prescription costs were observed for target A and B drugs, irrespective of whether GPs were stratified into high, medium or low prescribers. When mean prescribing costs for PTC participants were compared with those of a control group comprising 8000 GPs over a 21-month period, PTC GPs decreased their costs by 2%, whereas drug costs for all Hessian physicians rose by 10%. Conclusions: PTCs appear to be an effective method to optimise the quality of drug prescribing and reduce drug costs.
  • Pharmacoeconomics, General-practice, Prescribing, Cost-analysis, Medical-education
  • RePEc:wkh:phecon:v:16:y:1999:i:3:p:273-283
Language
  • English
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