How many medications do doctors in primary care use? An observational study of the DU90% indicator in primary care in England

Chiedozie, Chiamaka; Murphy, Mark; Fahey, Tom; Moriarty, Frank

doi:10.1136/bmjopen-2020-043049

Cited by 3 publications

(3 citation statements)

References 49 publications

(53 reference statements)

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“…This has supported a rich ecosystem of teams both inside and outside the NHS using differing tools and approaches to monitor data and give feedback to GPs to improve prescribing. Analysis conducted on this NHS open data has also supported original research on a substantial range of prescribing topics, 21,23,[31][32][33][34] and data feedback to GPs has been shown to improve prescribing. [35][36][37][38] We strongly recommend that the HSE advances plans to publish similar data for GP prescribing in Ireland in…”

Section: Discussionmentioning

confidence: 57%

The impact of lidocaine plaster prescribing reduction strategies: A comparison of two national health services in Europe

Mattsson

Boland²,

Kirke³

et al. 2023

Brit J Clinical Pharma

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Aims In 2017, two distinct interventions were implemented in Ireland and England to reduce prescribing of lidocaine medicated plasters. In Ireland, restrictions on reimbursement were introduced through implementation of an application system for reimbursement. In England, updated guidance on items which should not be routinely prescribed in primary care, including lidocaine plasters, was published. This study aims to compare how the interventions impacted prescribing of lidocaine plasters in these countries. Methods We conducted an interrupted time‐series study using general practice data. For Ireland, monthly dispensing data (2015–2019) from the means‐tested General Medical Services (GMS) scheme was used. For England, data covered all patients. Outcomes were the rate of dispensings, quantity and costs of lidocaine plasters, and we modelled level and trend changes from the first full month of the policy/guidance change. Results Ireland had higher rates of lidocaine dispensings compared to England throughout the study period; this was 15.22/1000 population immediately pre‐intervention, and there was equivalent to a 97.2% immediate reduction following the intervention. In England, the immediate pre‐intervention dispensing rate was 0.36/1000, with an immediate reduction of 0.0251/1000 (a 5.8% decrease), followed by a small but significant decrease in the monthly trend relative to the pre‐intervention trend of 0.0057 per month. Conclusions Among two different interventions aiming to decrease low‐value lidocaine plaster prescribing, there was a substantially larger impact in Ireland of reimbursement restriction compared to issuing guidance in England. However, this is in the context of much higher baseline rates of use in Ireland compared to England.

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Section: Discussionmentioning

confidence: 57%

The impact of lidocaine plaster prescribing reduction strategies: A comparison of two national health services in Europe

Mattsson

Boland²,

Kirke³

et al. 2023

Brit J Clinical Pharma

Self Cite

View full text Add to dashboard Cite

show abstract

“…This has supported a rich ecosystem of teams both inside and outside the NHS using differing tools and approaches to monitor data and give feedback to GPs to improve prescribing. Analysis conducted on this NHS open data has also supported original research on a substantial range of prescribing topics 19,21,[29][30][31][32] ,and data feedback to GPs has been shown to improve prescribing [33][34][35][36] . We strongly recommend that the HSE advances plans to publish similar data for GPs prescribing in Ireland in line with national open data polices 37 .…”

Section: Discussionmentioning

confidence: 69%

The impact of lidocaine plaster prescribing reduction strategies: a comparison of two national health services in Europe

Mattsson

Boland²,

Kirke³

et al. 2023

Preprint

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Introduction In 2017, two distinct interventions were implemented in Ireland and England to reduce prescribing of lidocaine medicated plasters. In Ireland, restrictions on reimbursement were introduced. In England, updated guidance on items not to routinely prescribe in primary care, including lidocaine plasters, was published. This study aims to compare how the interventions impacted prescribing of lidocaine plasters in these countries. Methods We conducted an interrupted time series study using general practice data. For Ireland, monthly dispensing data (2015-2019) from the means-tested General Medical Services scheme was used. For England, data covered all patients. Outcomes were the rate of dispensings, quantity and costs of lidocaine plasters, and we modelled level and trend changes from the first full month of the policy/guidance change. Findings Ireland had higher rates of lidocaine dispensings compared to England throughout the study period; this was 15.22/1,000 population immediately pre-intervention, and there was equivalent to a 97.2% immediate reduction following the intervention. In England, the immediate pre-intervention dispensing rate was 0.36/1,000, with an immediate reduction of 0.0251/1,000 (a 5.8% decrease), followed by a small but significant decrease in the monthly trend relative to the pre-intervention trend of 0.0057 per month. Interpretation Among two different interventions aiming to decrease low-value lidocaine plaster prescribing, there was a substantially larger impact in Ireland of reimbursement restriction compared to issuing guidance in England. However, this is in the context of much higher baseline rates of use in Ireland compared to England. Funding This study was funded by the Health Research Board (SDAP-2019-023).

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“…We described patterns of antibiotic use with a drug utilisation 90%, defined as the number of antibiotics that accounted for 90% of the total antibiotics prescriptions. 5 Antibiotic prescriptions were classified on the basis of the Anatomical Therapeutical Chemical Classification (ATC Classification), WHO AWaRe and antibiotic classification in China were supplied by the detailed antibiotics in each category.…”

Section: Methodsmentioning

confidence: 99%

Antimicrobial prescribing for children in China: data from point prevalence surveys in 18 tertiary centres in China in 2016–2017

Zhang

et al. 2022

BMJ Open

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ObjectivesThe reports on evaluating the classification of antibiotic agents prescribed for Chinese children by combining WHO’s and China’s administrative categories were rare. This study aimed to investigate the pattern of antimicrobial agents prescribing for Chinese children in 2016.Settings18 tertiary centres from nine provinces located in northern, southern, eastern and western China.ParticipantsThe antimicrobial prescribing data from the children admitted in medical wards, surgical wards and intensive care units were collected and analysed. A total of 3680 antibiotic prescriptions for Chinese children were included in the analysis.Primary and secondary outcome measuresOne-day point-prevalence surveys (PPSs) on antimicrobial prescribing were conducted among hospitalised children in China between 1 February 2016 and 28 February 2017. Five hospitals participated in the first PPS, 13 hospitals in the second PPS, 17 hospitals in the third PPS and 18 hospitals in the fourth PPS. Patterns of antibiotic use with a drug utilisation of 90%, Anatomical Therapeutical Chemical Classification, WHO Access, Watch and Reserve (AWaRe) (version 2019) and antibiotic classification in China were described retrospectively.ResultsA total of 4442 children and 3680 antibiotic prescriptions for Chinese children were included in the analysis. 2900 (65.3%) children received at least one ongoing antibiotic during the survey days. On the basis of WHO AWaRe classification, the proportion of antibiotics in the Watch group was 76.5% (2814/3680). According to the Management of Antibiotic Classification in China, 56.8% (2089/3680) and 16.1% (594/3680) of antibiotic prescriptions in the Restricted group and the Special group, respectively, were included into broad-spectrum antibiotics. The most common indication for antibiotics was bacterial lower respiratory tract infection (2044/3680, 55.5%).ConclusionsThe use of broad-spectrum antibiotics was frequent and excessive in hospitalised children in China in 2016.

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How many medications do doctors in primary care use? An observational study of the DU90% indicator in primary care in England

Cited by 3 publications

References 49 publications

The impact of lidocaine plaster prescribing reduction strategies: A comparison of two national health services in Europe

The impact of lidocaine plaster prescribing reduction strategies: A comparison of two national health services in Europe

The impact of lidocaine plaster prescribing reduction strategies: a comparison of two national health services in Europe

Antimicrobial prescribing for children in China: data from point prevalence surveys in 18 tertiary centres in China in 2016–2017

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