Influence of prescription charges on repeat prescribing in primary care
Summary Background: Repeat dispensing by community pharmacists has now been rolled out nationally within England in order to improve patient convenience and reduce doctors’ workload. Little is known about how the charge status of the patient may impact on the uptake and prescribing practices of thi...
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| Veröffentlicht in: | Journal of clinical pharmacy and therapeutics Jg. 32; H. 3; S. 269 - 275 |
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| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
Oxford, UK
Blackwell Publishing Ltd
01.06.2007
Blackwell |
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| ISSN: | 0269-4727, 1365-2710 |
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| Abstract | Summary
Background: Repeat dispensing by community pharmacists has now been rolled out nationally within England in order to improve patient convenience and reduce doctors’ workload. Little is known about how the charge status of the patient may impact on the uptake and prescribing practices of this service.
Objective: To examine whether the charge status of the patient influences the length of the repeat prescribing cycle.
Method: Thirty‐six community pharmacies collected data on repeatable prescriptions dispensed over a 4‐month period. A purposive sample of 13 general practices actively involved as pathfinder sites were selected for interview, to explore views on repeat prescriptions and influence of prescription charges.
Results: Completed audit forms were collected on 4029 repeatable prescriptions. Differences in the length of the prescribing interval between charge payers and exempt patients were found to be statistically significant (Mann–Whitney U‐test, P < 0·001), indicating that prescribers were issuing prescriptions for longer interval periods for charge payers. Thirteen general practitioners (GPs) and three practice managers were interviewed across 13 practices. Some GPs varied their prescribing to minimize the cost to patients. Others were motivated to reduce waste and promoted 28‐day prescribing for all patients.
Conclusion: The study has shown that charge paying patients are more likely to have longer prescribing intervals and that cost to the patient is a consideration for GPs when making these decisions. Future work should explore the influence of other factors such as age, socio‐economic status and patient morbidity on prescribing in primary care. |
|---|---|
| AbstractList | Summary
Background: Repeat dispensing by community pharmacists has now been rolled out nationally within England in order to improve patient convenience and reduce doctors’ workload. Little is known about how the charge status of the patient may impact on the uptake and prescribing practices of this service.
Objective: To examine whether the charge status of the patient influences the length of the repeat prescribing cycle.
Method: Thirty‐six community pharmacies collected data on repeatable prescriptions dispensed over a 4‐month period. A purposive sample of 13 general practices actively involved as pathfinder sites were selected for interview, to explore views on repeat prescriptions and influence of prescription charges.
Results: Completed audit forms were collected on 4029 repeatable prescriptions. Differences in the length of the prescribing interval between charge payers and exempt patients were found to be statistically significant (Mann–Whitney U‐test, P < 0·001), indicating that prescribers were issuing prescriptions for longer interval periods for charge payers. Thirteen general practitioners (GPs) and three practice managers were interviewed across 13 practices. Some GPs varied their prescribing to minimize the cost to patients. Others were motivated to reduce waste and promoted 28‐day prescribing for all patients.
Conclusion: The study has shown that charge paying patients are more likely to have longer prescribing intervals and that cost to the patient is a consideration for GPs when making these decisions. Future work should explore the influence of other factors such as age, socio‐economic status and patient morbidity on prescribing in primary care. Repeat dispensing by community pharmacists has now been rolled out nationally within England in order to improve patient convenience and reduce doctors' workload. Little is known about how the charge status of the patient may impact on the uptake and prescribing practices of this service. To examine whether the charge status of the patient influences the length of the repeat prescribing cycle. Thirty-six community pharmacies collected data on repeatable prescriptions dispensed over a 4-month period. A purposive sample of 13 general practices actively involved as pathfinder sites were selected for interview, to explore views on repeat prescriptions and influence of prescription charges. Completed audit forms were collected on 4029 repeatable prescriptions. Differences in the length of the prescribing interval between charge payers and exempt patients were found to be statistically significant (Mann-Whitney U-test, P < 0.001), indicating that prescribers were issuing prescriptions for longer interval periods for charge payers. Thirteen general practitioners (GPs) and three practice managers were interviewed across 13 practices. Some GPs varied their prescribing to minimize the cost to patients. Others were motivated to reduce waste and promoted 28-day prescribing for all patients. The study has shown that charge paying patients are more likely to have longer prescribing intervals and that cost to the patient is a consideration for GPs when making these decisions. Future work should explore the influence of other factors such as age, socio-economic status and patient morbidity on prescribing in primary care. Repeat dispensing by community pharmacists has now been rolled out nationally within England in order to improve patient convenience and reduce doctors' workload. Little is known about how the charge status of the patient may impact on the uptake and prescribing practices of this service.BACKGROUNDRepeat dispensing by community pharmacists has now been rolled out nationally within England in order to improve patient convenience and reduce doctors' workload. Little is known about how the charge status of the patient may impact on the uptake and prescribing practices of this service.To examine whether the charge status of the patient influences the length of the repeat prescribing cycle.OBJECTIVETo examine whether the charge status of the patient influences the length of the repeat prescribing cycle.Thirty-six community pharmacies collected data on repeatable prescriptions dispensed over a 4-month period. A purposive sample of 13 general practices actively involved as pathfinder sites were selected for interview, to explore views on repeat prescriptions and influence of prescription charges.METHODThirty-six community pharmacies collected data on repeatable prescriptions dispensed over a 4-month period. A purposive sample of 13 general practices actively involved as pathfinder sites were selected for interview, to explore views on repeat prescriptions and influence of prescription charges.Completed audit forms were collected on 4029 repeatable prescriptions. Differences in the length of the prescribing interval between charge payers and exempt patients were found to be statistically significant (Mann-Whitney U-test, P < 0.001), indicating that prescribers were issuing prescriptions for longer interval periods for charge payers. Thirteen general practitioners (GPs) and three practice managers were interviewed across 13 practices. Some GPs varied their prescribing to minimize the cost to patients. Others were motivated to reduce waste and promoted 28-day prescribing for all patients.RESULTSCompleted audit forms were collected on 4029 repeatable prescriptions. Differences in the length of the prescribing interval between charge payers and exempt patients were found to be statistically significant (Mann-Whitney U-test, P < 0.001), indicating that prescribers were issuing prescriptions for longer interval periods for charge payers. Thirteen general practitioners (GPs) and three practice managers were interviewed across 13 practices. Some GPs varied their prescribing to minimize the cost to patients. Others were motivated to reduce waste and promoted 28-day prescribing for all patients.The study has shown that charge paying patients are more likely to have longer prescribing intervals and that cost to the patient is a consideration for GPs when making these decisions. Future work should explore the influence of other factors such as age, socio-economic status and patient morbidity on prescribing in primary care.CONCLUSIONThe study has shown that charge paying patients are more likely to have longer prescribing intervals and that cost to the patient is a consideration for GPs when making these decisions. Future work should explore the influence of other factors such as age, socio-economic status and patient morbidity on prescribing in primary care. |
| Author | Ashcroft, D. M. Elvey, R. Noyce, P. Bradley, F. |
| Author_xml | – sequence: 1 givenname: F. surname: Bradley fullname: Bradley, F. organization: Centre for Innovation in Practice, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK – sequence: 2 givenname: R. surname: Elvey fullname: Elvey, R. organization: Centre for Innovation in Practice, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK – sequence: 3 givenname: D. M. surname: Ashcroft fullname: Ashcroft, D. M. organization: Centre for Innovation in Practice, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK – sequence: 4 givenname: P. surname: Noyce fullname: Noyce, P. organization: Centre for Innovation in Practice, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK |
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| Keywords | charges Medical prescription Primary health care prescription general practice repeat prescribing |
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| References | Zermansky A (1996) Who controls repeats? British Journal of General Practice, 46, 643-647. Pharmaceutical Services Negotiating Committee (2004) The new contract for community pharmacy. Aylesbury: PSNC. McKinnon M, Townsend J, Cooper J, Hunt B, Patel J (2001) Systematic review and clinical governance in repeat prescribing in general practice. Primary Health Care Research and Development, 2, 235-240. House of Commons Health Committee (2004) NHS charges: third report of session 2005-06. 18-7-2006. London: The Stationery Office Ltd. Atella V, Schafheutle E, Noyce P, Hassell K (2005) Affordability of medicines and patients' cost-reducing behaviour. Applied Health Economics and Health Policy, 4, 23-35. McGavock H, Wilson-Davis K, Connolly JP (1999) Repeat prescribing management - a cause for concern? British Journal of General Practice, 49, 343-347. Weiss MC, Hassell K, Schafheutle E, Noyce P (2001) Strategies used by general practitioners to minimise the impact of the prescription charge. European Journal of General Practice, 7, 23-26. House of Commons Hansard Written Answers (2001) Prescription charges. Column: 572W. 7-2-2001. London: The Stationery Office Ltd. Information Centre for Health and Social Care (2006). Prescriptions dispensed in the community: statistics for 1995 to 2005. Leeds: Information Centre for Health and Social Care. Harris C, Dajda R (1996) The scale of repeat prescribing. British Journal of General Practice, 46, 649-653. Elvey R, Ashcroft D, Noyce P (2006) Repeat dispensing: the benefits for GPs, pharmacists and patients. Prescriber, 17, 12-18. Schafheutle E, Hassell K, Noyce P, Weiss MC (2002) Access to medicines: cost as an influence on the views and behaviour of patients. Health and Social Care in the Community, 10, 187-195. 2005; 4 2006 2001; 2 2004 2001 2001; 7 1996; 46 1999; 49 2006; 17 2002; 10 House of Commons Hansard Written Answers (b2_71) 2001 Elvey R (b11_80) 2006; 17 Zermansky A (b7_76) 1996; 46 b3_72 McGavock H (b8_77) 1999; 49 b4_73 b9_78 Information Centre for Health and Social Care (b1_70) 2006 Pharmaceutical Services Negotiating Committee (b10_79) 2004 Weiss MC (b5_74) 2001; 7 Harris C (b6_75) 1996; 46 House of Commons Health Committee (b12_81) 2004 |
| References_xml | – reference: Harris C, Dajda R (1996) The scale of repeat prescribing. British Journal of General Practice, 46, 649-653. – reference: Elvey R, Ashcroft D, Noyce P (2006) Repeat dispensing: the benefits for GPs, pharmacists and patients. Prescriber, 17, 12-18. – reference: McGavock H, Wilson-Davis K, Connolly JP (1999) Repeat prescribing management - a cause for concern? British Journal of General Practice, 49, 343-347. – reference: House of Commons Hansard Written Answers (2001) Prescription charges. Column: 572W. 7-2-2001. London: The Stationery Office Ltd. – reference: Weiss MC, Hassell K, Schafheutle E, Noyce P (2001) Strategies used by general practitioners to minimise the impact of the prescription charge. European Journal of General Practice, 7, 23-26. – reference: McKinnon M, Townsend J, Cooper J, Hunt B, Patel J (2001) Systematic review and clinical governance in repeat prescribing in general practice. Primary Health Care Research and Development, 2, 235-240. – reference: House of Commons Health Committee (2004) NHS charges: third report of session 2005-06. 18-7-2006. London: The Stationery Office Ltd. – reference: Information Centre for Health and Social Care (2006). Prescriptions dispensed in the community: statistics for 1995 to 2005. Leeds: Information Centre for Health and Social Care. – reference: Zermansky A (1996) Who controls repeats? British Journal of General Practice, 46, 643-647. – reference: Schafheutle E, Hassell K, Noyce P, Weiss MC (2002) Access to medicines: cost as an influence on the views and behaviour of patients. Health and Social Care in the Community, 10, 187-195. – reference: Atella V, Schafheutle E, Noyce P, Hassell K (2005) Affordability of medicines and patients' cost-reducing behaviour. Applied Health Economics and Health Policy, 4, 23-35. – reference: Pharmaceutical Services Negotiating Committee (2004) The new contract for community pharmacy. Aylesbury: PSNC. – volume: 10 start-page: 187 year: 2002 end-page: 195 article-title: Access to medicines: cost as an influence on the views and behaviour of patients publication-title: Health and Social Care in the Community – volume: 46 start-page: 649 year: 1996 end-page: 653 article-title: The scale of repeat prescribing publication-title: British Journal of General Practice – volume: 7 start-page: 23 year: 2001 end-page: 26 article-title: Strategies used by general practitioners to minimise the impact of the prescription charge publication-title: European Journal of General Practice – volume: 46 start-page: 643 year: 1996 end-page: 647 article-title: Who controls repeats publication-title: British Journal of General Practice – volume: 49 start-page: 343 year: 1999 end-page: 347 article-title: Repeat prescribing management – a cause for concern publication-title: British Journal of General Practice – volume: 4 start-page: 23 year: 2005 end-page: 35 article-title: Affordability of medicines and patients’ cost‐reducing behaviour publication-title: Applied Health Economics and Health Policy – volume: 2 start-page: 235 year: 2001 end-page: 240 article-title: Systematic review and clinical governance in repeat prescribing in general practice publication-title: Primary Health Care Research and Development – year: 2001 – year: 2006 – year: 2004 – volume: 17 start-page: 12 year: 2006 end-page: 18 article-title: Repeat dispensing: the benefits for GPs, pharmacists and patients publication-title: Prescriber – volume: 46 start-page: 649 year: 1996 ident: b6_75 publication-title: British Journal of General Practice – volume: 17 start-page: 12 year: 2006 ident: b11_80 publication-title: Prescriber doi: 10.1002/psb.389 – ident: b4_73 doi: 10.2165/00148365-200504010-00005 – volume-title: The new contract for community pharmacy year: 2004 ident: b10_79 – volume-title: NHS charges: third report of session 2005-06 year: 2004 ident: b12_81 – volume-title: Prescription charges. year: 2001 ident: b2_71 – volume: 49 start-page: 343 year: 1999 ident: b8_77 publication-title: British Journal of General Practice – ident: b3_72 doi: 10.1046/j.1365-2524.2002.00356.x – volume: 7 start-page: 23 year: 2001 ident: b5_74 publication-title: European Journal of General Practice doi: 10.3109/13814780109048780 – volume: 46 start-page: 643 year: 1996 ident: b7_76 publication-title: British Journal of General Practice – ident: b9_78 doi: 10.1191/146342301682157719 – volume-title: Prescriptions dispensed in the community: statistics for 1995 to 2005 year: 2006 ident: b1_70 |
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Background: Repeat dispensing by community pharmacists has now been rolled out nationally within England in order to improve patient convenience and... Repeat dispensing by community pharmacists has now been rolled out nationally within England in order to improve patient convenience and reduce doctors'... |
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| SubjectTerms | Adolescent Adult Biological and medical sciences charges Community Pharmacy Services - statistics & numerical data Cost Savings - methods Data Collection - methods Data Collection - statistics & numerical data Drug Costs - statistics & numerical data Drug Prescriptions - economics Drug Prescriptions - statistics & numerical data Drug Utilization Review - methods Drug Utilization Review - statistics & numerical data England general practice Humans Management Audit - methods Management Audit - statistics & numerical data Medical sciences Middle Aged Pharmacology. Drug treatments Physicians, Family - statistics & numerical data Practice Management, Medical - statistics & numerical data Practice Patterns, Physicians prescription Primary Health Care - economics Primary Health Care - methods Primary Health Care - trends repeat prescribing Time Factors |
| Title | Influence of prescription charges on repeat prescribing in primary care |
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