The use of GP electronic medical records for international comparisons on prescription.

Verheij, R., Dijk, L. van, Pringle, M., Elliott, C., Fleming, D.M. The use of GP electronic medical records for international comparisons on prescription. European Journal of Public Health: 2007, 17(suppl. 2) 75. Abstract. 15th Annual EUPHA Meeting: "The future of public health in the Unified Europe", Helsinki, 11-13 oktober 2007.
Aims: Much international research on prescription does not take into account the associated diagnoses. Subsequently, large scale international comparisons on what is prescribed for which disease are relatively rare. Routinely collected GP electronic medical records, whose use is well established in many European countries, have much potential to solve this problem because they often hold information on diagnosis as well as prescriptions. We will provide an overview of EU countries possessing networks routinely collecting diagnosis and prescription data and discuss some pitfalls and limitations of international comparisons of such data. Design and methods: An inventory of available GP networks in Europe was performed. Furthermore, results of the electronic Health Indicator Data (eHID) project are presented. The eHID is an EC sponsored project concerned with best practice in recording diagnostic data in routinely collected electronic medical recordings (EMRs) in general practice and their analysis and interpretation on disease incidence and prevalence and national differences in health care access and provision of services. Results: In Europe there are at least five nationally representative EMR based networks collecting diagnosis and prescriptions. In the eHID project these were able to provide incidence and prevalence data on diabetes and on ischaemic heart disease, which could be reasonably compared after due consideration of the different healthcare systems. The provision of comparable data on mental illness presented more difficulties. The difficulties of making direct comparisons were identified and solutions to them derived. The optimum methods to achieve comparable data were formulated as recommendations that will be presented. Conclusions: There are opportunities for pharmacological research based on GP electronic medical records. Recommendations from the eHID project are useful to enable us to interpret international prescribing differences correctly. (aut. ref.)