Core medication use in general practice prescriptions: A pilot study evaluating the Drug Utilization 90% Index in Irish general practice.

IF 3.1 3区医学 Q2 PHARMACOLOGY & PHARMACY British journal of clinical pharmacology Pub Date : 2024-12-08 DOI:10.1111/bcp.16356

Caroline McCarthy, Patrick Moynagh, Tom Fahey, Fiona Boland, Frank Moriarty

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Abstract

Aims: The Drug Utilization 90% Index (DU90%), the number of medicines making up 90% of a doctor's prescribing, is a simple tool that can be used to describe core prescribing patterns. This research aimed to pilot the application of the DU90% in the Irish context, to investigate the relationship between the DU90% and prescriber and practice characteristics and prescribing quality.

Methods: Retrospective observational study using anonymous prescription data from a sample of Irish general practitioners (GPs). Participating GPs provided demographic details and extracted prescription data for 2018-2022 using their existing software systems. The DU90% was calculated annually at both the practice and prescriber level. Prescribing quality indicators included antibiotic, benzodiazepine prescribing rates and high-risk nonsteroidal anti-inflammatory drug prescribing. The association of the DU90% with prescriber and practice characteristics and prescribing quality indicators was explored with multilevel modelling.

Results: Thirty-eight prescribers from 22 different practices were included. The mean DU90% for prescribers was 141.5 (standard deviation 12.9) and for practices was 145.62 (standard deviation 11.87). Practices in receipt of the rural deprivation grant had a significantly lower DU90% (incidence rate ratio 0.94, 95% confidence interval 0.88-0.98). There was no evidence of an association between prescriber-level characteristics and the DU90% (sex, years qualified, number of sessions worked). There was a small positive relationship between the prescriber DU90% and total prescriptions, antibiotic and benzodiazepine prescribing rates, and higher rates of high-risk nonsteroidal anti-inflammatory drug prescriptions.

Conclusion: Applying the DU90% to Irish general practice prescriptions is feasible, revealing that GPs typically use 140 medicines in the bulk of their prescribing.

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核心药物使用在一般做法处方：试点研究评估药物利用90%指数在爱尔兰一般做法。

目的：药物利用90%指数（DU90%），即占医生处方90%的药物数量，是一个简单的工具，可用于描述核心处方模式。本研究旨在在爱尔兰背景下试点DU90%的应用，调查DU90%与处方者和实践特征以及处方质量之间的关系。方法：回顾性观察研究使用匿名处方数据从爱尔兰全科医生（全科医生）的样本。参与的全科医生使用他们现有的软件系统提供了2018-2022年的人口统计细节并提取了处方数据。DU90%是每年在执业和处方水平上计算的。处方质量指标包括抗生素、苯二氮卓类药物的处方率和高危非甾体类抗炎药的处方率。采用多层模型探讨了DU90%与处方者和实践特征以及处方质量指标的关系。结果：纳入22种不同做法的38名处方者。处方者的平均DU90%为141.5（标准差12.9），执业者的平均DU90%为145.62（标准差11.87）。接受农村贫困补助的做法的DU90%明显较低（发病率比0.94,95%可信区间0.88-0.98）。没有证据表明处方水平特征与DU90%（性别、合格年数、有效疗程数）之间存在关联。处方者DU90%与总处方、抗生素和苯二氮卓类药物处方率以及高风险非甾体类抗炎药处方率之间存在较小的正相关关系。结论：将DU90%应用于爱尔兰全科医生处方是可行的，这表明全科医生通常在他们的处方中使用140种药物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British journal of clinical pharmacology 医学-药学

CiteScore

6.30

自引率

8.80%

发文量

419

审稿时长

1 months

期刊介绍： Published on behalf of the British Pharmacological Society, the British Journal of Clinical Pharmacology features papers and reports on all aspects of drug action in humans: review articles, mini review articles, original papers, commentaries, editorials and letters. The Journal enjoys a wide readership, bridging the gap between the medical profession, clinical research and the pharmaceutical industry. It also publishes research on new methods, new drugs and new approaches to treatment. The Journal is recognised as one of the leading publications in its field. It is online only, publishes open access research through its OnlineOpen programme and is published monthly.