Family Practice Advance Access originally published online on July 29, 2005
Family Practice 2005 22(6):624-630; doi:10.1093/fampra/cmi074
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Differences in prescribing between GPs. Impact of the cooperation with pharmacists and impact of visits from pharmaceutical industry representatives
a Division Healthcare, CZ Health Insurance Company, Sittard, b Centre for Quality of Care Research (WOK), Maastricht University and University of Nijmegen, c Centre for Data and Information Management, Maastricht University, d Maasland Hospital, Department of Clinical Pharmacy and Toxicology, Sittard and e Netherlands School of Primary Care Research, Maastricht University, The Netherlands.
Correspondence to Paul EM Muijrers, CZ Health Insurance Company, PO Box 55, 6130MA, Sittard, The Netherlands; Email: paul.muijrers{at}hag.unimaas.nl
Background. Community pharmacists, pharmaceutical industry and differences in prescribing between GPs.
Objective. To explore the role of the pharmacists and pharmaceutical industry representatives.
Methods. A cross-sectional survey was undertaken of 1434 GPs in The Netherlands in 2001. Prescribing indicators based on general practice guidelines were used to assess the quality of prescribing. Three constructs, based on survey questions, were used as possible determinants for the quality of prescribing: cooperation with the pharmacist; quality of the Pharmacotherapeutic audit meeting (PTAM); and the GP's attitude towards the pharmacist's role. Data were collected about the frequency of visits by pharmaceutical industry representatives. Responses from 324 solo GPs were analysed using multiple linear regression.
Results. Response rate: 71%. For the 324 solo GPs the average score for the 20 prescribing indicators was 64% (SD 3.7). For the non-solo GPs this score was 65% (SD 3.8, P < 0.05). The differences between solo and group practices were: the number of visits from pharmaceutical industry representatives (5.7 versus 3.8 visits per month), full time GPs (93% versus 50%), the number of patients per GP (2151, SD 693 versus 1506, SD 742), and the presence of a GP trainer (21 versus 38%). Of the solo GPs, 4.6% are female, compared with 26% of the GPs in non-solo practices. The quality of prescribing in solo practices was not correlated with the GP's attitude towards the pharmacist's role, the way in which GPs cooperated with pharmacists or the quality of the PTAM. More frequent visits from pharmaceutical industry representatives was associated with a lower quality of prescribing.
Conclusion. There was a negative correlation between quality of prescribing by solo GPs and frequency of visits by pharmaceutical industry representatives. In day-to-day practice, no measurable effects of the cooperation between solo GP and pharmacist on the quality of prescribing were observed.
Keywords. Co-operation, GP, indicators, pharmaceutical industry, pharmacist.
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