[Ongoing improvement in the quality of chronic prescriptions at a primary care center: a 5-year follow-up].
OBJECTIVE
To find how the indicators for prescriptions for the chronically ill during the 1988-1992 period evolved, based on the analysis of the repeat prescription archive; and to assess the persistence of the effect of the 1989 corrective intervention.


METHODS
A retrospective and longitudinal evaluation study.


METHODS
Primary Care Centre.


METHODS
Four representative samples of patients with an ongoing prescription card for 1988 (n = 549), 1989 (n = 211), 1990 (n = 193) and 1992 (n = 126).


RESULTS
Indicators used were: percentage of patients in treatment with some medication of low intrinsic value (LIV), benzodiazepines, peripheric vasodilators (PV), oral non-steroidal anti-inflammatories (NSAID), external NSAID and the percentage of each one of these out of the prescription total. A progressive decrease in the percentage of LIV medication in the 1988-1992 period was detected. There were significant differences, both for oral anti-diabetes drugs of high intrinsic value (HIV) (24.4 and 12.7%), and of LIV (26.6 and 16.9%) (p < 0.001 in both cases). Benzodiazepines went down from 5.4 to 1.2% (p = 0.0006), PVs from 4.4 to 1.2% (p = 0.003) and oral NSAID from 4.7 to 2.4% (p = 0.049). The percentage of patients treated with LIV medication went down from 46.1 to 29.4% (p < 0.001) and from 52.4 to 38.1% (p = 0.004), for HIV and LIV oral anti-diabetes drugs, respectively. Patients treated with benzodiazepines went down from 14.7 to 4.0% (p = 0.0017), with PV from 12.0 to 3.2% (p = 0.005) and with oral NSAID from 12.7 to 7.9% (ns).


CONCLUSIONS
A continuous improvement in the quality of prescription for the chronically ill has been observed over the last 5 years and can be attributed to the primary care team.
Mata Cases
M
M
ABS La Mina, Unidad Docente de Medicina Familiar y Comunitaria de Barcelona.
Avellana Revuelta
E
E
Davins Miralles
J
J
Calvet Junoy
S
S
Hortelano García
M A
MA
Martín López
A
A
D016009:Chi-Square Distribution; D003151:Community Health Centers / Q000592:standards* / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000592:standards* / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D013030:Spain
Mejora continua de la calidad de la prescripción crónica en un centro de atención primaria: seguimiento de 5 años.