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. 2000 Aug 12;321(7258):425-8.
doi: 10.1136/bmj.321.7258.425.

Prescribing indicators for UK general practice: Delphi consultation study

S M Campbell  1 , J A Cantrill, D Roberts
Affiliations

Prescribing indicators for UK general practice: Delphi consultation study

S M Campbell et al. BMJ. .

Abstract

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.

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Example of feedback on indicators included in second round questionnaire
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References

    1. Department of Health. Quality in the new NHS: a first class service. London: DoH; 1998.
    1. Secretary of State for Health. The new NHS. London: Stationery Office; 1998. . (Cm 3807.)
    1. Prescribing Support Unit. Prescribing measures and the application. An explanation. Leeds: PSU; 1998.
    1. National Prescribing Centre and NHS Executive. GP Prescribing Support Unit—a resource document for the new NHS. London: NPC, NHSE; 1998.
    1. Audit Commission. A prescription for improvement: towards more rational prescribing in general practice. London: HMSO; 1994.

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