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Benchmarking helps GPs reduce risky prescribing

Giving GPs regular feedback on how safe their prescribing is relative to other practices helped them to cut out potentially hazardous prescriptions, research has shown.

The study, published in the BMJ, involved over 250 practices across three Scottish health boards.

Practices were split into three groups, one of which was provided with standard educational materials while the others were sent feedback every quarter on how often they had issued high-risk prescriptions of antipsychotics, NSAIDs and antiplatelets, and how this compared to a benchmark based on the 25% safest prescribing GP practices the previous year.

One of the groups given feedback was also provided with extra information to encourage them to search for and review patients who might be vulnerable to high-risk prescribing.

After 15 months, the practices that received the regular feedback cut the odds of issuing a potentially risk prescription by 12%, compared with the standard approach.

Those that received the extra information as well as feedback reduced the odds of high-risk prescribing slightly further, by 14%.

The researchers, led by Professor Bruce Guthrie at the University of Dundee, concluded: ‘Feedback of prescribing safety data was effective at reducing high-risk prescribing.

‘The intervention would be feasible to implement at scale in contexts where electronic health records are in general use.’

The same team recently showed that a financial incentive scheme to pay practices to review prescribing safety also helped to reduce high-risk prescribing.

BMJ 2016; available online 18 August

Readers' comments (4)

  • research and reality.big difference.

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  • Excellent has helped improve quality and made us better GP's great!

    - anonymous salaried!

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  • feedback and follow up is decisive.

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  • Quite so.This should be a mutually supportive exercise rather than name and shame outliers, but frankly, if you are prescribing,say,five times more antibiotics than Practices with comparable demographics, you need to be able to justify this.
    Prescribing should be for patients' needs not their wants, and exercises like this can support GPs in modifying their clinical practice.

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