General practitioners prefer prescribing indicators based on detailed information on individual patients: a Delphi study.
OBJECTIVE
To assess the face validity of both simple and advanced quality indicators for prescribing in general practice.


METHODS
In a three-round Delphi study, 100 randomly selected general practitioners (GPs) in Denmark rated 18 indicators for prescribing of non-steroidal anti-inflammatory drugs. All indicators were based on prescription register data and focused on different prescribing aspects. Advanced indicators contained information at the patient level, viz. age, sex and history of drug use, while simple indicators only used drug statistics at practice level. Indicators were rated on a nine-point Likert scale. Consensus among GPs was defined as interquartile ranges of three or less. A median rating of 7-9 was interpreted as face validity and a median rating of 1-3 as no face validity.


RESULTS
Participation in the study was accepted by 44 GPs and 37 completed all three rounds. Three indicators based on patient level data and focusing on adverse effects were assessed to have face value. One indicator focusing on costs and based on practice level data was considered unsuitable for evaluating the quality of prescribing. Consensus was not reached for the remaining indicators.


CONCLUSIONS
GPs do not regard simple indicators based on aggregated data at practice level as suitable for evaluating the prescribing quality in general practice, but prefer indicators that rest on clinical data at the patient level.
Rasmussen
Hanne M S
HM
Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Winsløwparken 19, 3, DK-5000, Odense, Denmark. hra@dkma.dk
Søndergaard
Jens
J
Kampmann
Jens P
JP
Andersen
Morten
M
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics / Q000627:therapeutic use; D032921:Consensus; D003697:Delphi Technique; D011307:Drug Prescriptions; D006801:Humans; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000592:standards* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012042:Registries / Q000706:statistics & numerical data
D000894:Anti-Inflammatory Agents, Non-Steroidal