1. Practice allocation list
Is the provision of patient level prescribing data by an effective and acceptable means of influencing prescribing behaviour? Carol M. Smart1, Sean MacBride-Stewart1, Anne C. Boyter2. 1Pharmacy and Prescribing Support Unit , West Glasgow Ambulatory Care Hospital, Dalnair St, Glasgow 2Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow
Background
Unsolicited mailed feedback to prescribers of historical prescription data has been deemed ineffective at influencing future prescribing behaviour.1 Although many quantitative studies have shown no impact on prescribing patterns, there is little evidence to explain why GPs have not acted on the data provided. Prescribing Information System (PIS) data allows reports to filter prescribing data down to a patient level. Consideration should be given to determine if the provision of patient level analysis is a factor that would encourage GPs to act on the information contained in prescribing feedback reports.
Aim
Results
SIZE OF REPORT /
TIME TO ACTION
SUBJECT MATTER
EVIDENCE
INCLUDED
PATIENT DETAILS
To determine prescribers’ opinions of ed prescribing feedback that includes patient level data and to identify any barriers that may prevent them from acting on the data provided.
“We all want to improve our prescribing-… it’s just that there’s no time.”
“ Its too long… if it was a nice punchy one page…probably acted on it more quickly ”
“Obviously we look at the bits we like…bits we don’t like we ignore”
“..that’s easy to do.. because somebody has done the work for me… here is all the reference to it… here is all the clinical evidence”
“It’s all the referencing at the start, it’s all there… you could go and read more widely about it”
“Went over and above… wanting to help us... and doing background work... and the evidence and references”
“..to do with safety and quality… that was one we dealt with quickly”
“because it let us review live data rather than just getting feedback… compared to other practices”
“ I think it’s very specific”
“…useful to us…I think it was a tighter subject…often get prescribing feedback that is very generic on all antibiotics”
“It was more detailed.. It was right down to patient level data… which was good”
“It was reassuring to me that these patients were being flagged up out with the practice”
“ very helpful to have the names there…I liked the personalised….”
“This is interesting…I just don’t have time to do this”
Design and Setting
Qualitative interview study with GPs from two Health and Social Care Partnerships (HSCP) within NHS Scotland.
Methodology
After obtaining participant consent, semi-structured interviews with GPs in NHS Scotland were audio recorded and transcribed verbatim at a later date. Thematic analysis of interview content was conducted with the use of NVivo® software.
EPIPP2
Randomised
Practice allocation list
NE HSCP
2 GP Practices Topic 1
3 GP Practices Topic 2
Other HSCP
1 GP Practice Topic 1
“It is very specific…someone has looked at our data…and is helping to review our patients”
Conclusion
ing patient level analysis of prescribing data was welcomed
GPs are experiencing ever increasing demands on their time: for maximum uptake of prescribing feedback recommendations, the reports must:
Be concise
Pertain to a specific clinical topic
Identify patients
Provide evidence and references to support the clinical topic
References
Ivers N, Jamtvedt G, Flottorp S, Young JM, Odgaard-Jensen J, French SD, et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012;6.
McBride-Stewart S. Study Protocol: Electronic Prescription Data to Improve Primary Care Prescribing EPIPP (Clinical Trial NCT ); accessed 20th November 2016