Drug utilisation 90% profiles--a useful tool for quality assessment of prescribing in primary health care in Stockholm.
OBJECTIVE
To analyse strengths and weaknesses of a simple method for assessing the general quality of drug prescribing and to study the acceptance of the method among general practitioners (GPs).


METHODS
Prescriptions dispensed during October-December 1999 and 2000, respectively, were analysed for 38 Primary Health Care centres (PHC) in Stockholm participating in an intervention project with the aim of increasing cost-consciousness among GPs. Focus was on quality of prescribing rather than on costs. Prescribing profiles focusing on the number of drugs constituting 90% of the volume (= DU90%) and the adherence to local drug committee guideline within this segment were presented for the prescribers. The credibility and usefulness of the method was evaluated by a questionnaire.


RESULTS
Among the PHCs, the total number of drugs prescribed varied between 358 and 674. The number of drugs in the DU90%-segment varied between 117 and 194. The adherence to guideline within this segment varied between 56% and 74% and increased over time. The prescribers found the DU90%-profiles clear and relevant and considered the method to be a useful tool for improving the quality of drug prescribing.


CONCLUSIONS
Providing DU90%-profiles with guideline adherence as feedback was shown to be a valuable tool in general practice for assessing the overall quality in prescribing and to form the basis for more disease- or patient-specific analyses.
Wettermark
Björn
B
Department of Medical Laboratory Sciences, Division of Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden. bjorn.wettermark@apoteket.se
Pehrsson
Ake
A
Jinnerot
Dane
D
Bergman
Ulf
U
D000367:Age Factors; D001291:Attitude of Health Personnel; D003151:Community Health Centers / Q000191:economics / Q000639:trends; D011307:Drug Prescriptions; D017723:Drug Utilization Review / Q000191:economics / Q000379:methods*; D019983:Guideline Adherence / Q000191:economics / Q000639:trends; D006801:Humans; D010821:Physicians, Family; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards* / Q000639:trends; D011785:Quality Assurance, Health Care / Q000191:economics / Q000379:methods*; D013548:Sweden