R P Wilson1, J Hatcher, S Barton, T Walley. 1. Department of Pharmacology and Therapeutics, Pembroke Place, University of Liverpool, Liverpool L69 3GF, UK.
Abstract
BACKGROUND: The prescribing volume of benzodiazepines and of appetite suppressant drugs have been suggested as possible indicators of prescribing quality. OBJECTIVE: To investigate the variation among general practices in the prescribing of benzodiazepines and appetite suppressants by examining the contribution to this variation of training status, partnership status, fundholding status and the level of deprivation in the practice population. METHODS: Prescribing data (PACT) were analysed for 350 practices in the former Mersey Regional Health Authority, for the year ending March 1991 and the year ending March 1994. Data were first standardized for variation in practice population demography. Multiple linear regressions were used to investigate the variation among practices in standardized prescribing volume in both years. RESULTS: For benzodiazepines, training status and partnership status contributed to all models and level of deprivation contributed to some (percentage of variation explained for year ending March 1991: 10% to 21%, year ending March 1994: 8% to 20%). For appetite suppressant drugs fundholding status and an interaction between training status and level of deprivation contributed to all models in both years (percentage of variation explained for year ending March 1991: 19% to 20%, year ending March 1994: 20% to 21%). CONCLUSION: The prescribing of benzodiazepines is lower in training practices, in multi-partner practices and in practices serving a less deprived population, while the prescribing of appetite suppressant drugs is lower in training practices and in fundholding practices. Variation in prescribing knowledge, organizational and management capabilities and patient demand may be explanatory factors. Copyright 1998 John Wiley & Sons, Ltd.
BACKGROUND: The prescribing volume of benzodiazepines and of appetite suppressant drugs have been suggested as possible indicators of prescribing quality. OBJECTIVE: To investigate the variation among general practices in the prescribing of benzodiazepines and appetite suppressants by examining the contribution to this variation of training status, partnership status, fundholding status and the level of deprivation in the practice population. METHODS: Prescribing data (PACT) were analysed for 350 practices in the former Mersey Regional Health Authority, for the year ending March 1991 and the year ending March 1994. Data were first standardized for variation in practice population demography. Multiple linear regressions were used to investigate the variation among practices in standardized prescribing volume in both years. RESULTS: For benzodiazepines, training status and partnership status contributed to all models and level of deprivation contributed to some (percentage of variation explained for year ending March 1991: 10% to 21%, year ending March 1994: 8% to 20%). For appetite suppressant drugs fundholding status and an interaction between training status and level of deprivation contributed to all models in both years (percentage of variation explained for year ending March 1991: 19% to 20%, year ending March 1994: 20% to 21%). CONCLUSION: The prescribing of benzodiazepines is lower in training practices, in multi-partner practices and in practices serving a less deprived population, while the prescribing of appetite suppressant drugs is lower in training practices and in fundholding practices. Variation in prescribing knowledge, organizational and management capabilities and patient demand may be explanatory factors. Copyright 1998 John Wiley & Sons, Ltd.