Use of a clinical audit to promote the quality use of medicines to rural and remote general practitioners.
Very few methods have been shown to change prescribing behaviour. Queensland Rural Medical Support Agency's Quality Use of Medicines (QUM) Program aims to engage rural general practitioners (GPs) in the development of strategies to improve health outcomes in relation to the quality use of medicines. The present paper describes the development of a tool to audit the management of heart failure in rural general practice and to encourage rural GPs to undertake such an audit as a method of continuing medical education. A self-administered retrospective clinical audit of heart failure patients was undertaken by rural and remote GPs. Fourteen doctors undertook the audit, providing data on 270 patient cases. Patient data collected include 30% not receiving adequate angiotensin-converting enzyme inhibitor doses, 45% of patients who may benefit from a beta-blocker and 14% of patients taking a drug known to aggravate heart failure. The majority of participants would review a patient following the audit and 93% confirmed that the audit assisted them in identifying patients whose heart failure management could be enhanced. The clinical audit provided results and a commentary to allow GPs reflective educational opportunities through the dissemination of results and engagement with appropriate educational organisations (e.g. Australian College of Rural and Remote Medicine) to inform the development of educational standards for personal development programs in QUM. Audits must be relevant and practical to meet the learning needs of GPs.
Cutts
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Queensland Rural Medical Support Agency, PO Box 167, Kelvin Grove, QLD 4059, Australia. christopher@qrmsq.com.au
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002983:Clinical Competence / Q000592:standards; D011307:Drug Prescriptions / Q000592:standards*; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education / Q000592:standards*; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008485:Medical Audit / Q000379:methods*; D011793:Queensland; D019035:Rural Health Services / Q000592:standards*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors