[Impact of various objectives related to the rational use of medication in a primary care area].
OBJECTIVE
To evaluate the impact of the application of objectives relating to the rational use of medication and to assess the possible effect of these objectives on pharmaceutical expenditure.


METHODS
A non-randomised intervention study with control.


METHODS
Santiago de Compostela Primary Care (PC) Area.


METHODS
After the inclusion and exclusion criteria were applied, both the intervention group (IG) and the control group (CG) consisted of 31 doctors. Those in the IG belonged to the reformed PC model, whereas those in the CG did not.


METHODS
Four blocks of objectives on the rational use of medication were included in the Pact signed by reformed-model doctors and the management. The study lasted three years (1996-1998) for the objective of lowering the prescription of low-therapeutic-utility (LTU) drugs, and two years (1997-1998) for lowering the prescription of antihypertensives, Triflusal and quinolones.


RESULTS
The difference between both groups was 1.7 fewer packs of LTU drugs per 1000 users and per day in the IG (95% CI, 0.9-2.6) and 1768 pesetas less (95% CI, 801-2733). These differences were still greater among pensioners. The difference between the two groups in terms of total pharmaceutical cost was 7379 pesetas less in the IG (95% CI, 708-14,049) than in the CG. The differences between the groups for the remaining objectives (antihypertensives, Triflusal and quinolones) in no case reached statistical significance.


CONCLUSIONS
The pharmaceutical objectives of the pact were partly achieved: a drop in LTU drug prescription was seen, with an indirect reduction in overall expenditure, but no differences were found in the prescription of antihypertensives, triflusal or quinolones.
Segade Buceta
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Xerencia de Atención Primaria de Santiago, A Coruña.
D000959:Antihypertensive Agents / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D011307:Drug Prescriptions / Q000191:economics; D004363:Drug Utilization; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011320:Primary Health Care; D015363:Quinolones / Q000627:therapeutic use; D012179:Retirement; D012459:Salicylates / Q000627:therapeutic use; D013030:Spain; D014505:Urban Population
D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors; D015363:Quinolones; D012459:Salicylates; C016167:triflusal