RESUMEN
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Asunto(s)
Humanos , España , Cooperación del Paciente , Atención Primaria de Salud , QuimioterapiaRESUMEN
OBJECTIVE: To evaluate the impact of the recommendations in the bulletin of pharmacotherapeutic information on the prescription of iron salts by the area's doctors. DESIGN: Intervention study with control group. SETTING: Two primary care areas in Asturias. PARTICIPANTS: Intervention group: 93 doctors from area 3. CONTROL GROUP: 59 doctors from area 7. INTERVENTIONS: In March 97 an informative bulletin was issued recommending the use of ferrous salts rather than ferric salts and was sent to all area 3's doctors. MEASUREMENTS AND MAIN RESULTS: The PFe2 indicator was calculated: defined daily dose percentage of ferrous salts out of total iron salts in three time periods: January-March '97 (t1), April-June '97 (t2) and January-March '98 (t3). In the intervention group, the PFe2 value increased progressively in the three periods. There were significant differences between t1 and t3 (mean increase: 6.0%, 95% CI: 1.9%-10.1%, p = 0.004) and between t2 and t3 (mean increase: 4.5%, 95% CI 0.8%-8.3%, p = 0.017), whereas the differences were not significant between t1 and t2 (mean increase 1.5%, 95 CI 1.3%-4.2%, p = 0.296). The respective values for the controls only showed significant differences for variation in periods t2 and t3 (mean increase: 2.0%, 95% CI 0.2%-3.8%, p = 0.017). CONCLUSIONS: 1. The bulletin issued in the area had a favourable impact. 2. This impact could only be seen in the medium term, not in the short term.
Asunto(s)
Prescripciones de Medicamentos , Quimioterapia , Servicios de Información , Estudios de Casos y Controles , Áreas de Influencia de Salud , Etiquetado de Medicamentos , España , Factores de TiempoRESUMEN
BACKGROUND: The constant gauging of drug prescription quality is part of the health-care process quality improvement programs as regards Primary Care, but generally speaking, there are no tried and true indicators which can be used in this assessment process. Measuring the degree to which certain set drugs are adhered to as a district-wide guide regarding which a consensus of opinion has been reached can be used as an overall indicator of prescribing-related quality. The objective of this study is that of setting out a method for selecting quality indicators of generalizing type, the same serving as an example with regard to selecting an indicator for gauging the degree to which the district guide is followed. METHODS: Descriptive cross-sectional study entailing the general practitioners in the Health Care District of Avilés (n = 78) as the individual district analyzed, and the prescriptions written thereby which were invoiced in 1997 as the data source. Seven (7) indicators were prepared for gauging the degree to which the District Drug Therapy Guide was followed. A selection was made by studying the following aspects: reliability, ready availability, accuracy, sensitivity, specificity and coherence. RESULTS: The scores fell within the 10-23 range (out of a possible 28), the highest score being that of the percentage of prescriptions for active ingredients out of the guide in comparison to the total number of prescriptions written by each physician. CONCLUSIONS: The indicators used in assessing drug-prescribing quality must first be analyzed in detail before being implemented. An innovative method is suggested for testing indicators for monitoring the prescribing of drugs as a whole. The most useful of all of the indicators studied for gauging the degree to which the Primary Care drug therapy guide was being followed is the percentage of prescriptions written for active ingredients out of the total number of prescriptions written. The degree to which the District Drug Therapy Guide is followed is related positively to quality prescribing.