BMJ 2000;321:425 ( 12 August )

General Practice

Prescribing indicators for UK general practice: Delphi consultation study

Stephen M Campbell, research fellowa Judy A Cantrill, clinical senior lecturera Dave Roberts, managerb

a National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL, b Prescribing Support Unit, Brunswick Court, Leeds LS2 7RJ

Correspondence to: S M Campbell stephen.campbell{at}man.ac.uk

Objectives: To identify prescribing indicators based on prescribing analysis and cost (PACT) data that have face validity for measuring quality or cost minimisation.
Design: Modified two round Delphi questionnaire requiring quantitative and qualitative answers.
Setting: Health authorities in England.
Participants: All health authority medical and pharmaceutical advisers in the first round and lead prescribing advisers for each health authority in the second round.
Main outcome measures: Face validity (median rating of 7-9 on a nine point scale without disagreement) and reliability (rating 8 or 9) of indicators for assessing quality and cost minimisation.
Results: Completed second round questionnaires were received from 79 respondents out of 99. The median rating was 7 for cost minimisation and 6 for quality, and in all except four cases individual respondents rated indicators significantly higher for cost than for quality. Of the 41 indicators tested, only seven were rated valid and reliable for cost minimisation and five for quality.
Conclusion: The 12 indicators rated as valid by leading prescribing advisers had a narrow focus and would allow only a limited examination of prescribing at a general practice, primary care group, or health authority level.



© BMJ 2000

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Articles

Developing a quality criteria framework for patient decision aids: online international Delphi consensus process
Glyn Elwyn, Annette O'Connor, Dawn Stacey, Robert Volk, Adrian Edwards, Angela Coulter, Richard Thomson, Alexandra Barratt, Michael Barry, Steven Bernstein, Phyllis Butow, Aileen Clarke, Vikki Entwistle, Deb Feldman-Stewart, Margaret Holmes-Rovner, Hilary Llewellyn-Thomas, Nora Moumjid, Al Mulley, Cornelia Ruland, Karen Sepucha, Alan Sykes, Tim Whelan The International Patient Decision Aids Standards (IPDAS) Collaboration
BMJ 2006 333: 417. [Abstract] [Full Text] [PDF]

Prescription pricing databases should include more details to assess prescribing rationality
Hugh McGavock
BMJ 2001 322: 173. [Extract] [Full Text]

UK prescribing indicators have limited value in assessing practice
BMJ 2000 321: 0. [Full Text]

This article has been cited by other articles:

  • Cronin, E., Campbell, S., Ashworth, M., Hann, M., Blashki, G., Murray, J., Tylee, A. (2009). A tale of two systems: perceptions of primary care for depression in London and Melbourne. Fam Pract 26: 210-220 [Abstract] [Full text]  
  • Kavanagh, P L, Adams, W G, Wang, C J (2009). Quality indicators and quality assessment in child health. Arch. Dis. Child. 94: 458-463 [Abstract] [Full text]  
  • Martirosyan, L, Braspenning, J, Denig, P, de Grauw, W J C, Bouma, M, Storms, F, Haaijer-Ruskamp, F M (2008). Prescribing quality indicators of type 2 diabetes mellitus ambulatory care. Qual Saf Health Care 17: 318-323 [Abstract] [Full text]  
  • Coenen, S., Ferech, M., Haaijer-Ruskamp, F. M, Butler, C. C, Vander Stichele, R. H, Verheij, T. J M, Monnet, D. L, Little, P., Goossens, H., the ESAC Project Group, (2007). European Surveillance of Antimicrobial Consumption (ESAC): quality indicators for outpatient antibiotic use in Europe. Qual Saf Health Care 16: 440-445 [Abstract] [Full text]  
  • Mourad, S.M., Hermens, R.P.M.G., Nelen, W.L.D.M., Braat, D.D.M., Grol, R.P.T.M., Kremer, J.A.M. (2007). Guideline-based development of quality indicators for subfertility care. Hum Reprod 22: 2665-2672 [Abstract] [Full text]  
  • Elwyn, G., O'Connor, A., Stacey, D., Volk, R., Edwards, A., Coulter, A., Thomson, R., Barratt, A., Barry, M., Bernstein, S., Butow, P., Clarke, A., Entwistle, V., Feldman-Stewart, D., Holmes-Rovner, M., Llewellyn-Thomas, H., Moumjid, N., Mulley, A., Ruland, C., Sepucha, K., Sykes, A., Whelan, T., The International Patient Decision Aids Standards, (2006). Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ 333: 417- [Abstract] [Full text]  
  • Puumalainen, I. I, Kause, J. M, Airaksinen, M. S (2005). Quality Assurance Instrument Focusing on Patient Counseling. The Annals of Pharmacotherapy 39: 1220-1226 [Abstract] [Full text]  
  • Thompson, B, MacAuley, D, McNally, O, O'Neill, S (2004). Defining the sports medicine specialist in the United Kingdom: a Delphi study. Br. J. Sports. Med. 38: 214-217 [Abstract] [Full text]  
  • Love, T., Dowell, A. C, Salmond, C., Crampton, P. (2004). Quality indicators and variation in primary care: modelling GP referral patterns. Fam Pract 21: 160-165 [Abstract] [Full text]  
  • MORRIS, C. J., CANTRILL, J. A., HEPLER, C. D., NOYCE, P. R. (2002). Preventing drug-related morbidity--determining valid indicators. Int J Qual Health Care 14: 183-198 [Abstract] [Full text]  
  • Heaney, D. J, Walker, J. J, Howie, J. G., Maxwell, M., Freeman, G. K, Berrey, P. N., Jones, T. G, Stern, M. C, Campbell, S. M (2002). The development of a routine NHS data-based index of performance in general practice (NHSPPI). Fam Pract 19: 77-84 [Abstract] [Full text]  
  • Campbell, S M, Braspenning, J, Hutchinson, A, Marshall, M (2002). Research methods used in developing and applying quality indicators in primary care. Qual Saf Health Care 11: 358-364 [Abstract] [Full text]  
  • Millar, M. R., Russell, E., Karcher, A. M., Neville, L., Portia, O.-B. (2001). Prescribing quality is not synonymous with cost minimization for antibiotics. J Antimicrob Chemother 47: 367-368 [Full text]  
  • McGavock, H. (2001). Prescription pricing databases should include more details to assess prescribing rationality. BMJ 322: 173-173 [Full text]  

Rapid Responses:

Read all Rapid Responses

More patient-centred prescribing indicators are needed
Andrew Thornett
bmj.com, 18 Aug 2000 [Full text]
Combining PACT based indicators with disease prevelance may be useful when measuring quality
S H Guptha
bmj.com, 28 Aug 2000 [Full text]
Deceptive Information
Alexander Williams
bmj.com, 13 Sep 2000 [Full text]



Access jobs at BMJ Careers
Whats new online at Student 

BMJ