Repeat prescribing: which diagnoses, which drugs?

Background-Repeat prescribing should be limited to drugs which are to be prescribed on a long-term basis to patients whose conditions are stable. Early studies were based on small sample sizes. The definition of repeat prescribing has not been consistent and interpractice variation in repeat prescribing has not been described.Aims-To describe the diagnostic categories and anatomical groups associated with repeat prescriptions; to describe interpractice variation associated with repeat prescribing and to describe the repeat to consultation ratio for the most frequently prescribed diagnoses and drugs.Method-Doctors from a stratified quota sample of 22 Northern Ireland practices recorded their perceived diagnosis for every consultation and for every repeat prescription over a 2-week period.Results-The diagnostic categories significantly associated with repeat prescriptions were digestive, cardiovascular, neurological, psychiatric and metabolic ( p < 0.0001). The anatomical drug categories significantly associated with repeat prescriptions were gastrointestinal drugs, cardiovascular drugs, central nervous system drugs, dressings and appliances (p < 0.0001). There was wide interpractice variation in repeat prescribing (both overall and for individual anatomical groups) and associated diagnoses. High repeat to consultation ratios were recorded for ranitidine, temazepam and diazepan.Conclusions-Wide interpractice variation in repeat prescribing and associated diagnoses revealed poor consensus among practices. Therefore, the approach to the management of common conditions - whether to consult or issue a repeat prescription - was not uniform. The implications of these findings require further research. Commonly occurring diagnoses and drugs had unacceptably high repeat to consultation ratios. Copyright (c) 2000 John Wiley & Sons, Ltd.