Inquiry calls for new measures to deter GPs from prescribing drugs for minor illnesses

By Lilian Anekwe

GPs should be measured on their ability to prescribe ‘alternatives' to antibiotics and painkillers when managing acute illnesses in primary care, according to a report commissioned by the King's Fund.

A review of the management of acute illness, commissioned by the King's Fund as part of its ongoing inquiry into general practice, argued new measures are needed to prevent GPs' overreliance on antibiotics and painkillers.

The independent research team, which included several GP academics, suggested that quality indicators could be developed to encourage GPs to use alternative medications to antibiotics, such as paracetamol or inhalations, to treat minor self-limiting infections that are likely to be viral in origin.

GPs should also be encouraged to avoid using non-steroidal anti-inflammatory drugs (NSAIDs), because of the associated risks of cardiovascular disease and upper gastrointestinal bleeds.

Other alternatives GPs could use include information leaflets, physiotherapy referral, advice about exercises and posture, and heat treatment.

The research team, led by Professor Roger Jones, professor of general practice at King's College London, concluded: ‘Quality indicators could be derived to measure the range and proportion of consultations that result in the prescription of an analgesic.'

‘Quality indicators could also be derived to promote the use of alternatives to analgesic prescriptions, recognising that in many situations analgesic prescriptions for acute pain may be a positive consultation outcome.'

A second research paper, also published as part of the inquiry, examined the role of general practice in health promotion and ill health prevention.

It concluded that GPs will have an increasing responsibility to prevent illness and promote health, and that future contract negotiations around GP commissioning should assign responsibility for primary and secondary prevention of diseases.