Prescribing indicators for UK general practice: Delphi consultation study.
OBJECTIVE
To identify prescribing indicators based on prescribing analysis and cost (PACT) data that have face validity for measuring quality or cost minimisation.


METHODS
Modified two round Delphi questionnaire requiring quantitative and qualitative answers.


METHODS
Health authorities in England.


METHODS
All health authority medical and pharmaceutical advisers in the first round and lead prescribing advisers for each health authority in the second round.


METHODS
Face validity (median rating of 7-9 on a nine point scale without disagreement) and reliability (rating 8 or 9) of indicators for assessing quality and cost minimisation.


RESULTS
Completed second round questionnaires were received from 79 respondents out of 99. The median rating was 7 for cost minimisation and 6 for quality, and in all except four cases individual respondents rated indicators significantly higher for cost than for quality. Of the 41 indicators tested, only seven were rated valid and reliable for cost minimisation and five for quality.


CONCLUSIONS
The 12 indicators rated as valid by leading prescribing advisers had a narrow focus and would allow only a limited examination of prescribing at a general practice, primary care group, or health authority level.
National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL. stephan.campbell@man.ac.uk
S M
SM
Campbell
J A
JA
Cantrill
D
D
Roberts
D003697:Delphi Technique; D016527:Drug Costs; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data*; D004739:England; D005194:Family Practice / Q000191:economics / Q000592:standards; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000191:economics / Q000592:standards; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results; D013222:State Medicine / Q000191:economics* / Q000592:standards; D011795:Surveys and Questionnaires