Inappropriate drug prescriptions for elderly patients are common in general practice. Since the majority of the prescribing practice is made up by rather few diagnoses and drugs, improved practice for only a few may nevertheless have a large impact on the total profile.
To investigate general practitioners' drug prescribing patterns for children (0–12 y), an observational, cross‐sectional study was conducted in Western Norway. Seven thousand, two hundred and twenty‐nine GP‐patient contacts during which 5222 drugs were prescribed, were included for analysis. The highest prescribing rates were for boys <2y (82.1 prescriptions per 100 contacts). Two‐thirds of all prescriptions were for drugs in main groups respiratory system or systemic antiinfectives. The 20 most commonly prescribed agents comprised 75% of all prescriptions. The 20 most frequently recorded diagnoses for prescribing comprised 81% of all. Phenoxymethylpenicillin was the most frequently prescribed antibiotic for otitis, tonsillitis and sinusitis, while erythromycin was used most often for bronchitis and pneumonia. Antibiotics were prescribed in more than 8/10 contacts for tonsillitis, sinusitis, acute bronchitis and pneumonia, and in two‐thirds of all contacts for urinary tract infections. Sixty‐five percent of the antibiotic prescriptions for urinary tract infections were for co‐trimoxazole.
ObjectiveThe main objective of this paper is to investigate whether incorporating an electronic optional guideline tool (EOGT) in the standardized referral template used by general practitioners (GPs) when referring patients to specialized care can improve outpatient referral appropriateness.DesignIntervention study with an intervention and a control group.Setting210 GPs in the municipality of Bergen and the Department of Thoracic Medicine at Haukeland University Hospital.Subjects2400 patients referred to the Department of Thoracic Medicine at Haukeland University Hospital.ResultsAn electronic optional guideline tool (EOGT) was implemented on 93 of 210 GPs’ computer systems. The referral quality and the time spent reviewing each referral were evaluated by the hospital specialists. The GPs did not know that their referrals were being evaluated. The specialists were blinded with regard to information concerning the intervention and the control group. The specialists reported significantly higher referral quality and considerably less time spent on evaluating referrals when using the EOGT, with an overall time reduction of 34%. Likewise, GPs also reported that the EOGT was easy to use, time-saving and led to an improved quality of their referrals.ConclusionThis study documents an improvement in the quality of the referrals. Since the GPs save time by using the EOGT, there is no reason to believe that they will discontinue using it. In fact, the tool may be even more beneficial for the GP. The authors believe that it is possible to implement the EOGT as a standard referral tool within various fields of medicine and are currently in the process of developing these tools.
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