Skip to main content
Log in

Repeat Prescribing

Scale, Problems and Quality Management in Ambulatory Care Patients

Drugs Aims and scope Submit manuscript

Abstract

The reported scale of repeat prescriptions ranges from 29% to 75% of all items prescribed, depending on the definition of repeat prescribing and other variables. It is likely that a substantial part of repeat prescribing by general practitioners (GPs) occurs without direct doctor-patient contact. While this reduces the workload for the GP and is convenient for the patient, it does not provide the adequate control that is needed to ensure that every repeat prescription is still appropriate, effective and well tolerated, and that it is still being viewed upon and taken by the patient as intended. Infrequent therapy reviews may lead to failure to prevent, identify and solve drug-related problems and drug wastage, and may, thereby, have a negative impact on the effectiveness, safety or cost of the medications prescribed.

Studies evaluating the repeat prescribing process have shown that GPs and medical practices vary widely in their degree of administrative and clinical control of repeat prescriptions. Contrary to the opinion that GPs cannot change prescribing behaviour when the prescription is initiated by a medical specialist, GPs have their own responsibility for controlling the repeats of such prescriptions.

Intervention studies suggest that a medication review by a pharmacist can help to reduce drug-related problems with repeat prescriptions, and the effectiveness of the intervention may be increased by combining the medication review with a consultation of the patient’s medical records and a patient interview. In several studies, such an intervention was relatively inexpensive and, therefore, feasible. However, these conclusions should be viewed with appropriate caution because a number of caveats pertain. There is still no evidence that these types of intervention improve health-related quality of life or reduce healthcare cost, and so far only a few trials have produced any evidence of clinical improvement. As implicit and explicit screening criteria have their own benefits and limitations, a combined application may offer a more thorough assessment but may also be more complex and time consuming.

Further studies on the development and evaluation of repeat prescription management models are needed, preferably focussing on improving clinical, humanistic and economic outcomes. New studies should investigate the effects of: different types of interventions; different organisational models; different target populations; and selecting and training different types of healthcare professionals. Future studies should also assess whether results are sustained, the optimal time interval between reviews of repeat prescriptions, and the possibilities offered by new computerised support technologies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II
Table III
Table IV

Similar content being viewed by others

References

  1. Muir AJ, Sanders LL, Wilkinson WE, et al. Reducing medication regimen complexity: a controlled trial. J Gen Intern Med 2001; 16: 77–82

    Article  PubMed  CAS  Google Scholar 

  2. Khunti K, Kinsella B. Effect of systematic review of medication by general practitioner on drug consumption among nursinghome residents. Age Ageing 2000; 29: 451–3

    Article  PubMed  CAS  Google Scholar 

  3. Faulkner MA, Wadibia EC, Lucas BD, et al. Impact of pharmacy counseling on compliance and effectiveness of combination lipid-lowering therapy in patients undergoing coronary artery revascularization: a randomized, controlled trial. Pharmacotherapy 2000; 20: 410–6

    Article  PubMed  CAS  Google Scholar 

  4. Rodgers S, Avery AJ, Meechan D, et al. Controlled trial of pharmacist intervention in general practice: the effect on prescribing costs. Br J Gen Pract 1999; 49: 717–20

    PubMed  CAS  Google Scholar 

  5. Schrader SL, Dressing B, Blue R, et al. The Medication Reduction Project: combating polypharmacy in South Dakota elders through community-based interventions. S D J Med 1996; 49: 441–8

    PubMed  CAS  Google Scholar 

  6. Carter BL, Malone DC, Valuck RJ, et al. The IMPROVE study: background and study design. Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers. Am J Health Syst Pharm 1998; 55: 62–7

    PubMed  CAS  Google Scholar 

  7. Wilson RG, Bojke C, O’Neill S, et al. Designing, specifying and evaluating a new repeat prescribing process for UK general practice. Stud Health Technol Inform 2000; 77: 219–23

    PubMed  CAS  Google Scholar 

  8. National Audit Office. Repeat prescribing by general medical practitioners in England: HC 897. London: HM Stationary Office, 1993

    Google Scholar 

  9. Purves I, Kennedy J. The quality of general practice repeat prescribing. Newcastle upon Tyne, UK: The Sowerby Unit for Primary Care Informatics, University of Newcastle, 1994 [online]. Available from URL: http://www.schin.ncl.ac.uk/RepeatPrescribing/material/reports/repeat%20prescribing%201%20report.pdf [Accessed 2003 Jul 6]

  10. Sykes D, Westwood P, Gilleghan J. Development of a review programme for repeat prescription medicines. Pharm J 1996; 256: 458–60

    Google Scholar 

  11. Zermansky AG. Who controls repeats? Br J Gen Pract 1996; 46: 643–7

    PubMed  CAS  Google Scholar 

  12. Harris CM, Dajda R. The scale of repeat prescribing. Br J Gen Pract 1996; 46: 649–53

    PubMed  CAS  Google Scholar 

  13. Granås AG, Bates I. The effect of pharmaceutical review of repeat prescriptions in general practice. Int J Pharm Pract 1999; 7: 264–75

    Article  Google Scholar 

  14. Rokstad K, Straand J. Drug prescribing during direct and indirect contacts with patients in general practice: a report from the More & Romsdal Prescription Study. Scand J Prim Health Care 1997; 15: 103–8

    Article  PubMed  CAS  Google Scholar 

  15. Davidson W, Collett J, Jackson C, et al. Identification and costs of prescriber-defined repeat prescribing. Int J Pharm Pract 1997; 5: 46–9

    Article  Google Scholar 

  16. Feely J, Chan R, McManus J, et al. The influence of hospital-based prescribers on prescribing in general practice. Pharmacoeconomics 1999; 16: 175–81

    Article  PubMed  CAS  Google Scholar 

  17. Straand J, Rokstad KS. Elderly patients in general practice: diagnoses, drugs and inappropriate prescriptions: a report from the More & Romsdal Prescription Study. Fam Pract 1999; 16: 380–8

    Article  PubMed  CAS  Google Scholar 

  18. Bond C, Matheson C, Williams S, et al. Repeat prescribing: a role for community pharmacists in controlling and monitoring repeat prescriptions. Br J Gen Pract 2000; 50: 271–5

    PubMed  CAS  Google Scholar 

  19. Goldstein R, Hulme H, Willits J. Reviewing repeat prescribing: general practitioners and community pharmacists working together. Int J Pharm Pract 1998; 6: 60–6

    Article  Google Scholar 

  20. McGavock H, Wilson-Davis K, Connolly JP. Repeat prescribing management: a cause for concern? Br J Gen Pract 1999; 49: 343–7

    PubMed  CAS  Google Scholar 

  21. Quinn R, Kelly A. How much of a general practitioner’s prescribing is outside his/her control? Ir Med J 1998; 91: 168–72

    PubMed  CAS  Google Scholar 

  22. Corry M, Bonner G, McEntee S, et al. Hospitals do not inform GPs about medication that should be monitored. Fam Pract 2000; 17: 268–71

    Article  PubMed  CAS  Google Scholar 

  23. de Vries CS, van Diepen NM, Tromp TF, et al. Auditing GPs’ prescribing habits: cardiovascular prescribing frequently continues medication initiated by specialists. Eur J Clin Pharmacol 1996; 50: 349–52

    Article  PubMed  Google Scholar 

  24. Borgsdorf LR, Miano JS, Knapp KK. Pharmacist-managed medication review in a managed care system. Am J Hosp Pharm 1994; 51: 772–7

    PubMed  CAS  Google Scholar 

  25. Jameson J, VanNoord G, Vanderwoud K. The impact of a pharmacotherapy consultation on the cost and outcome of medical therapy. J Fam Pract 1995; 41: 469–72

    PubMed  CAS  Google Scholar 

  26. Cassidy IB, Keith MR, Coffey EL, et al. Impact of pharmacist-operated general medicine chronic care refill clinics on practitioner time and quality of care. Ann Pharmacother 1996; 30: 745–51

    PubMed  CAS  Google Scholar 

  27. Hanlon JT, Weinberger M, Samsa GP, et al. A randomized, controlled trial of a clinical pharmacist intervention to improve inappropriate prescribing in elderly outpatients with polypharmacy. Am J Med 1996; 100: 428–37

    Article  PubMed  CAS  Google Scholar 

  28. Hanlon JT, Landsman PB, Cowan K, et al. Physician agreement with pharmacist-suggested drug therapy changes for elderly outpatients. Am J Health Syst Pharm 1996; 53: 2735–7

    PubMed  CAS  Google Scholar 

  29. Cowper PA, Weinberger M, Hanlon JT, et al. The cost-effectiveness of a clinical pharmacist intervention among elderly outpatients. Pharmacotherapy 1998; 18: 327–32

    PubMed  CAS  Google Scholar 

  30. Burtonwood AM, Hinchliffe AL, Tinkler GS. A prescription for quality: a role for the clinical pharmacist in general practice. Pharm J 1998; 261: 678–80

    Google Scholar 

  31. Grymonpre RE, Williamson DA, Montgomery PR. Impact of a pharmaceutical care model for non-institutionalised elderly: results of a randomised, controlled trial. Int J Pharm Pract 2001; 9: 235–41

    Article  Google Scholar 

  32. Jones J, Matheson C, Bond C. Patient satisfaction with a community pharmacist-managed system of repeat prescribing. Int J Pharm Pract 2000; 8: 291–7

    Article  Google Scholar 

  33. Mackie CA, Lawson DH, Campbell A, et al. A randomised controlled trial of medication review in patients receiving polypharmacy in general practice [abstract]. Pharm J 1999; 263 Suppl.: R7

    Google Scholar 

  34. Monane M, Matthias DM, Nagle BA, et al. Improving prescribing patterns for the elderly through an online drug utilization review intervention: a system linking the physician, pharmacist, and computer. JAMA 1998; 280: 1249–52

    Article  PubMed  CAS  Google Scholar 

  35. Krass I, Smith C. Impact of medication regimen reviews performed by community pharmacists for ambulatory patients through liaison with general medical practitioners. Int J Pharm Pract 2000; 8: 111–20

    Article  Google Scholar 

  36. Jameson JP, VanNoord GR. Pharmacotherapy consultation on polypharmacy patients in ambulatory care. Ann Pharmacother 2001; 35: 835–40

    Article  PubMed  CAS  Google Scholar 

  37. Lowe CJ, Raynor DK, Purvis J, et al. Effects of a medicine review and education programme for older people in general practice. Br J Clin Pharmacol 2000; 50: 172–5

    Article  PubMed  CAS  Google Scholar 

  38. Ellis SL, Billups SJ, Malone DC, et al. Types of interventions made by clinical pharmacists in the IMPROVE study: Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers. Pharmacotherapy 2000; 20: 429–35

    Article  PubMed  CAS  Google Scholar 

  39. Malone DC, Carter BL, Billups SJ, et al. An economic analysis of a randomized, controlled, multicenter study of clinical pharmacist interventions for high-risk veterans: the IMPROVE study. Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers. Pharmacotherapy 2000; 20: 1149–58

    CAS  Google Scholar 

  40. Malone DC, Carter BL, Billups SJ, et al. Can clinical pharmacists affect SF-36 scores in veterans at high risk for medication-related problems? Med Care 2001; 39: 113–22

    Article  PubMed  CAS  Google Scholar 

  41. Ellis SL, Carter BL, Malone DC, et al. Clinical and economic impact of ambulatory care clinical pharmacists in management of dyslipidemia in older adults: the IMPROVE study. Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers. Pharmacotherapy 2000; 20: 1508–16

    CAS  Google Scholar 

  42. Sellors C, Dalby DM, Howard M, et al. Community-based family practices: a randomized, controlled trial in seniors. J Pharm Technol 2001; 17: 264–9

    Google Scholar 

  43. Allard J, Hebert R, Rioux M, et al. Efficacy of a clinical medication review on the number of potentially inappropriate prescriptions prescribed for community-dwelling elderly people. CMAJ 2001; 164: 1291–6

    PubMed  CAS  Google Scholar 

  44. Krska J, Cromarty JA, Arris F, et al. Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care. Age Ageing 2001; 30: 205–11

    Article  PubMed  CAS  Google Scholar 

  45. Zermansky AG, Petty DR, Raynor DK, et al. Randomised controlled trial of clinical medication review by a pharmacist of elderly patients receiving repeat prescriptions in general practice. BMJ 2001; 323: 1340–3

    Article  PubMed  CAS  Google Scholar 

  46. Zermansky AG, Petty DR, Raynor DK, et al. Clinical medication review by a pharmacist of patients on repeat prescriptions in general practice: a randomised controlled trial. Health Technol Assess 2002; 6(20): 1–86

    PubMed  CAS  Google Scholar 

  47. Petty DR, Zermansky AG, Raynor DK, et al. Clinical medication review by a pharmacist of elderly patients on repeat medications in general practice: pharmacist interventions and review outcomes. Int J Pharm Pract 2002; 10: 39–46

    Article  Google Scholar 

  48. Petty DR, Knapp P, Raynor DK, et al. Clinical medication review in general practice: what is the benefit of a second review [abstract]. Int J Pharm Pract 2002; 10 Suppl.: R70

    Article  Google Scholar 

  49. Krska J, Ross S. Medication review: whose job it is? [abstract]. Int J Pharm Pract 2002; 10 Suppl.: R86

    Article  Google Scholar 

  50. Sellors J, Kaczorowski J, Sellors C, et al. A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients. CMAJ 2003; 169: 17–22

    PubMed  Google Scholar 

  51. Starfield B, Powe NR, Weiner JR, et al. Costs vs quality in different types of primary care settings. JAMA 1994; 272: 1903–8

    Article  PubMed  CAS  Google Scholar 

  52. Warholak-Juarez T, Rupp MT, Salazar TA, et al. Effect of patient information on the quality of pharmacists’ drug use review decisions. J Am Pharm Assoc (Wash) 2000; 40: 500–8

    CAS  Google Scholar 

  53. Anderson GM, Lexchin J. Strategies for improving prescribing practice. CMAJ 1996; 154: 1013–7

    PubMed  CAS  Google Scholar 

  54. Grimshaw JM, Shirran L, Thomas R, et al. Changing provider behavior: an overview of systematic reviews of interventions. Med Care 2001; 39 Suppl. 2: II2–II45

    PubMed  CAS  Google Scholar 

  55. Mason JD, Colley CA. Effectiveness of an ambulatory care clinical pharmacist: a controlled trial. Ann Pharmacother 1993; 27: 555–9

    PubMed  CAS  Google Scholar 

  56. Majumdar SR, Soumerai SB. Why most interventions to improve physician prescribing do not seem to work. CMAJ 2003; 169: 30–1

    PubMed  Google Scholar 

  57. Britton ML, Lurvey PL. Impact of medication profile review on prescribing in a general medicine clinic. Am J Hosp Pharm 1991; 48: 265–70

    PubMed  CAS  Google Scholar 

  58. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm 1990; 47: 533–43

    PubMed  CAS  Google Scholar 

  59. Schmader KE, Hanlon JT, Landsman PB, et al. Inappropriate prescribing and health outcomes in elderly veteran outpatients. Ann Pharmacother 1997; 31: 529–33

    PubMed  CAS  Google Scholar 

  60. Shelton PS, Fritsch MA, Scott MA. Assessing medication appropriateness in the elderly: a review of available measures. Drugs Aging 2000; 16: 437–50

    Article  PubMed  CAS  Google Scholar 

  61. Zuckerman IH, Mulhearn DM, Metge CJ. Inter- and intrarater reliability of retrospective drug utilization reviewers. J Am Pharm Assoc (Wash) 1999; 39: 45–9

    CAS  Google Scholar 

  62. Soumerai SB, Lipton HL. Computer-based drug-utilization review: risk, benefit, or boondoggle? N Engl J Med 1995; 332: 1641–5

    Article  PubMed  CAS  Google Scholar 

  63. Hennessy S, Bilker WB, Zhou L, et al. Retrospective drug utilization review, prescribing errors, and clinical outcomes. JAMA 2003; 290: 1494–9

    Article  PubMed  CAS  Google Scholar 

  64. Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly: an update. Arch Intern Med 1997; 157: 1531–6

    Article  PubMed  CAS  Google Scholar 

  65. Aparasu RR, Mort JR. Inappropriate prescribing for the elderly: Beers criteria-based review. Ann Pharmacother 2000; 34: 338–46

    Article  PubMed  CAS  Google Scholar 

  66. Graal MB, Wolffenbuttel BH. The use of sulphonylureas in the elderly. Drugs Aging 1999; 15: 471–81

    Article  PubMed  CAS  Google Scholar 

  67. Stahl M, Berger W. Higher incidence of severe hypoglycaemia leading to hospital admission in type 2 diabetic patients treated with long-acting versus short-acting sulphonylureas. Diabet Med 1999; 16: 586–90

    Article  PubMed  CAS  Google Scholar 

  68. Meyer UA. Pharmacogenetics and adverse drug reactions. Lancet 2000; 356: 1667–71

    Article  PubMed  CAS  Google Scholar 

  69. Rogers JF, Nafziger AN, Bertino Jr JS. Pharmacogenetics affects dosing, efficacy, and toxicity of cytochrome P450-metabolized drugs. Am J Med 2002; 113: 746–50

    Article  PubMed  CAS  Google Scholar 

  70. Maitland-Van Der Zee AH, Klungel OH, Stricker BH, et al. Genetic polymorphisms: importance for response to HMG-CoA reductase inhibitors. Atherosclerosis 2002; 163: 213–22

    Article  Google Scholar 

  71. Cohen JS. Avoiding adverse reactions: effective lower-dose drug therapies for older patients. Geriatrics 2000; 55: 54–60,63

    PubMed  CAS  Google Scholar 

  72. Sproule BA, Hardy BG, Shulman KI. Differential pharmacokinetics of lithium in elderly patients. Drugs Aging 2000; 16: 165–77

    Article  PubMed  CAS  Google Scholar 

  73. Gosselink AT, van Veldhuisen DJ, Crijns HJ. When, and when not, to use digoxin in the elderly. Drugs Aging 1997; 10: 411–20

    Article  PubMed  CAS  Google Scholar 

  74. Chertow GM, Lee J, Kuperman GJ, et al. Guided medication dosing for inpatients with renal insufficiency. JAMA 2001; 286: 2839–44

    Article  PubMed  CAS  Google Scholar 

  75. Kirchheiner J, Brosen K, Dahl ML, et al. CYP2D6 and CYP2C19 genotype-based dose recommendations for antidepressants: a first step towards subpopulation-specific dosages. Acta Psychiatr Scand 2001; 104: 173–92

    Article  PubMed  CAS  Google Scholar 

  76. Macfarlane J, Prewett J, Rose D, et al. Prospective case-control study of role of infection in patients who reconsult after initial antibiotic treatment for lower respiratory tract infection in primary care. BMJ 1997; 315: 1206–10

    Article  PubMed  CAS  Google Scholar 

  77. Saunders K, Simon G, Bush T, et al. Assessing the feasibility of using computerized pharmacy refill data to monitor antidepressant treatment on a population basis: a comparison of automated and self-report data. J Clin Epidemiol 1998; 51: 883–90

    Article  PubMed  CAS  Google Scholar 

  78. Hirschfeld RM. Antidepressants in long-term therapy: a review of tricyclic antidepressants and selective serotonin reuptake inhibitors. Acta Psychiatr Scand Suppl 2000; 403: 35–8

    Article  PubMed  CAS  Google Scholar 

  79. Gray J, Majeed A, Kerry S, et al. Identifying patients with ischaemic heart disease in general practice: cross sectional study of paper and computerised medical records. BMJ 2000; 321: 548–50

    Article  PubMed  CAS  Google Scholar 

  80. Weideman RA, Bernstein IH, McKinney WP. Pharmacist recognition of potential drug interactions. Am J Health Syst Pharm 1999; 56: 1524–9

    PubMed  CAS  Google Scholar 

  81. Halkin H, Katzir I, Kurman I, et al. Preventing drug interactions by online prescription screening in community pharmacies and medical practices. Clin Pharmacol Ther 2001; 69: 260–5

    Article  PubMed  CAS  Google Scholar 

  82. Stewart RB, Cooper JW. Polypharmacy in the aged: practical solutions. Drugs Aging 1994; 4: 449–61

    Article  PubMed  CAS  Google Scholar 

  83. Hamdy RC, Moore SW, Whalen K, et al. Reducing polypharmacy in extended care. South Med J 1995; 88: 534–8

    Article  PubMed  CAS  Google Scholar 

  84. Williams BR, Nichol MB, Lowe B, et al. Medication use in residential care facilities for the elderly. Ann Pharmacother 1999; 33: 149–55

    Article  PubMed  CAS  Google Scholar 

  85. Wolfe MM, Lichtenstein DR, Singh G. Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs. N Engl J Med 1999; 340: 1888–99

    Article  PubMed  CAS  Google Scholar 

  86. Fastbom J, Claesson CB, Cornelius C, et al. The use of medicines with anticholinergic effects in older people: a population study in an urban area of Sweden. J Am Geriatr Soc 1995; 43: 1135–40

    PubMed  CAS  Google Scholar 

  87. Campbell SM, Roland MO, Shekelle PG, et al. Development of review criteria for assessing the quality of management of stable angina, adult asthma, and non-insulin dependent diabetes mellitus in general practice. Qual Health Care 1999; 8: 6–15

    Article  PubMed  CAS  Google Scholar 

  88. Bouvy ML, Heerdink ER, Klungel OH, et al. Women with angina pectoris receive less antiplatelet treatment than men. Br J Gen Pract 1999; 49: 299–300

    PubMed  CAS  Google Scholar 

  89. Romeijnders AC, Elders PJ. Summary of the guideline ‘Osteoporosis’ of the Dutch College of General Practitioners: Dutch College of General Practitioners [in Dutch]. Ned Tijdschr Geneeskd 1999; 143: 1611–4

    PubMed  CAS  Google Scholar 

  90. Diette GB, Wu AW, Skinner EA, et al. Treatment patterns among adult patients with asthma: factors associated with overuse of inhaled beta-agonists and underuse of inhaled corticosteroids. Arch Intern Med 1999; 159: 2697–704

    Article  PubMed  CAS  Google Scholar 

  91. Walters EH, Walters J. Inhaled short acting beta2-agonist use in asthma: regular vs as needed treatment (Cochrane Review). Cochrane Database Syst Rev 2000; (4): CD001285

  92. Anis AH, Lynd LD, Wang XH, et al. Double trouble: impact of inappropriate use of asthma medication on the use of health care resources. CMAJ 2001; 164: 625–31

    PubMed  CAS  Google Scholar 

  93. Diener HC, Kaube H, Limmroth V. A practical guide to the management and prevention of migraine. Drugs 1998; 56(5): 811–24

    Article  PubMed  CAS  Google Scholar 

  94. Steiner JF, Prochazka AV. The assessment of refill compliance using pharmacy records: methods, validity, and applications. J Clin Epidemiol 1997; 50: 105–16

    Article  PubMed  CAS  Google Scholar 

  95. Choo PW, Rand CS, Inui TS, et al. Validation of patient reports, automated pharmacy records, and pill counts with electronic monitoring of adherence to antihypertensive therapy. Med Care 1999; 37: 846–57

    Article  PubMed  CAS  Google Scholar 

  96. Jones JK, Gorkin L, Lian JF, et al. Discontinuation of and changes in treatment after start of new courses of antihypertensive drugs: a study of a United Kingdom population. BMJ 1995; 311: 293–5

    Article  PubMed  CAS  Google Scholar 

  97. Ambrosioni E, Leonetti G, Pessina AC, et al. Patterns of hypertension management in Italy: results of a pharmacoepidemiological survey on antihypertensive therapy. Scientific Committee of the Italian Pharmacoepidemiological Survey on Antihypertensive Therapy. J Hypertens 2000; 18: 1691–9

    CAS  Google Scholar 

  98. Murphy JE. Generic substitution and optimal patient care. Arch Intern Med 1999; 159: 429–33

    Article  PubMed  CAS  Google Scholar 

  99. Suh DC. Trends of generic substitution in community pharmacies. Pharm World sci 1999; 21: 260–5

    Article  PubMed  CAS  Google Scholar 

  100. McAlister FA, Laupacis A, Wells GA, et al. Users’ guides to the medical literature. XIX: applying clinical trial results B. Guidelines for determining whether a drug is exerting (more than) a class effect. JAMA 1999; 282: 1371–7

    Article  PubMed  CAS  Google Scholar 

  101. Furberg CD, Herrington DM, Psaty BM. Are drugs within a class interchangeable? Lancet 1999; 354: 1202–4

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

Peter De Smet works for the Scientific Institute Dutch Pharmacists, which is financially dependent on the Royal Dutch Society for the Advancement of Pharmacy (the professional pharmaceutical association in The Netherlands). The authors have no further sources of funding or conflicts of interest to declare.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Peter A. G. M. De Smet.

Rights and permissions

Reprints and permissions

About this article

Cite this article

De Smet, P.A.G.M., Dautzenberg, M. Repeat Prescribing. Drugs 64, 1779–1800 (2004). https://doi.org/10.2165/00003495-200464160-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-200464160-00005

Keywords

Navigation