期刊论文详细信息
BMC Family Practice
Prescriber variation in potentially inappropriate prescribing in older populations in Ireland
Research Article
Caitriona Cahir1  Kathleen Bennett1  Tom Fahey2  Conor Teljeur3 
[1] Department of Pharmacology & Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland;HRB Centre for Primary Care Research, , Division of Population Health Science, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland;Health Information and Quality Authority (HIQA), George’s Court, George’s Lane, Dublin 7, Ireland;
关键词: Potentially inappropriate prescribing;    General practice;    Prescriber variation;    STOPP;    Older populations;   
DOI  :  10.1186/1471-2296-15-59
 received in 2013-09-16, accepted in 2014-03-27,  发布年份 2014
来源: Springer
PDF
【 摘 要 】

BackgroundHealth care policy-makers look for prescribing indicators at the population level to evaluate the performance of prescribers, improve quality and control drug costs. The aim of this research was to; (i) estimate the level of variation in potentially inappropriate prescribing (PIP) across prescribers in the national Irish older population using the STOPP criteria; (ii) estimate how reliably the criteria could distinguish between prescribers in terms of their proportion of PIP and; (iii) examine how PIP varies between prescribers and by patient and prescriber characteristics in a multilevel regression model.Methods1,938 general practitioners (GPs) with 338,375 registered patients’ ≥70 years were extracted from the Health Service Executive Primary Care Reimbursement Service (HSE-PCRS) pharmacy claims database. HSE-PCRS prescriptions are WHO ATC coded. Demographic data for claimants’ and prescribers’ are available. Thirty STOPP indicators were applied to prescription claims in 2007. Multilevel logistic regression examined how PIP varied between prescribers and by individual patient and prescriber level variables.ResultsThe unadjusted variation in PIP between prescribers was considerable (median 35%, IQR 30-40%). The STOPP criteria were reliable measures of PIP (average >0.8 reliability). The multilevel regression models found that only the patient level variable, number of different repeat drug classes was strongly associated with PIP (>2 drugs v none; adjusted OR, 4.0; 95% CI 3.7, 4.3). After adjustment for patient level variables the proportion of PIP varied fourfold (0.5 to 2 times the expected proportion) between prescribers but the majority of this variation was not significant.ConclusionPIP is of concern for all prescribers. Interventions aimed at enhancing appropriateness of prescribing should target patients taking multiple medications.

【 授权许可】

CC BY   
© Cahir et al.; licensee BioMed Central Ltd. 2014

【 预 览 】
附件列表
Files Size Format View
RO202311093652882ZK.pdf 669KB PDF download
【 参考文献 】
  • [1]
  • [2]
  • [3]
  • [4]
  • [5]
  • [6]
  • [7]
  • [8]
  • [9]
  • [10]
  • [11]
  • [12]
  • [13]
  • [14]
  • [15]
  • [16]
  • [17]
  • [18]
  • [19]
  • [20]
  • [21]
  • [22]
  • [23]
  • [24]
  • [25]
  • [26]
  • [27]
  • [28]
  • [29]
  • [30]
  • [31]
  • [32]
  • [33]
  • [34]
  • [35]
  • [36]
  • [37]
  • [38]
  • [39]
  • [40]
  • [41]
  • [42]
  • [43]
  • [44]
  • [45]
  • [46]
  • [47]
  文献评价指标  
  下载次数:1次 浏览次数:0次