Improvement in prescribing can be measured only over time

doi:10.1136/bmj.322.7281.302/a

BMJ 2001;322:302 ( 3 February )

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Improvement in prescribing can be measured only over time

The first 150 words of the full text of this article appear below.

EDITOR $---$ Avery et al say that practices with lower prescribing costs prescribe less, use cheaper items, and avoid new and expensivedrugs.¹ A five year old managing their pocket money could havetold us the same basic economic statement. Without some look atclinical outcomes such studies are of little value. If in 10 yearsAvery et al could tell us that the low prescribers have just thesame rate of coronary events, bypass grafts, suicides, osteoporotichip fractures, and so forth as the high prescribers then theymight have made a useful point. Currently, with more and morepressure from our paymasters to raise standards and follow clinicalguidelines, some expensive prescribing is inevitable, unless weopt for therapeutic nihilism. That may simply shift the cost ofour prescribing budgets into secondary care management. It ischeaper for us to avoid prescribing inhaled steroids, for example,when the cost . . . [Full text of this article]

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A prescription for improvement? An observational study to identify how general practices vary in their growth in prescribing costs • Commentary: Beware regression to the mean: Anthony J Avery, Sarah Rodgers, Tara Heron, Robert Crombie, David Whynes, Mike Pringle, Darrin Baines, Roland Petchey, and T J Cole
BMJ 2000 321: 276-281. [Abstract] [Full Text] [PDF]