Variation in prescription of lipid lowering drugs: variation between general practices.
Dijk, L. van, Lindert, H. van, Westert, G. Variation in prescription of lipid lowering drugs: variation between general practices. European Journal of Public Health: 2003, 13(4 sup) 95. Abstract. 11th Annual Eupha Meeting 'Globalisation and Health in Europe: Harmonising Public Health Practices'. Rome, Italy, 20-22 November 2003.
Background: Lipid lowering drugs are frequently prescribed and expensive drugs. The prescription of lipid lowering drugs has strongly increased over the last few years. However, variation in prescription between general practitioners (GPs) is substantial. Aim: The aim of the study is to find out how prescription behavior of GPs combined with characteristics of patients leads to variation in prescribing lipid lowering drugs. Methods: Data from the Second Dutch National Survey of General Practice (DNSGP-2) are used. This survey was held in 2000/2001 and included 195 GPs working in 104 practices and their almost 400,000 patients. Data will be analysed using multilevel analyses for binary outcomes. The outcome variable is whether or not a patient received a prescription for lipid lowering drugs in the year of registration. The
explanatory variables are partly related to the GP (f.e. type of practice, has the GP a pharmacy, sex, use of information on drugs) and partly to the patient (f.e. (co)morbidity, co-medication, age, sex, ethnicity). Only patients aged 25 years and older are included in the analyses. Results: GPs prescribe on average a lipid lowering drug more than 3,5% of their patients during the year of registration (sd=1,4). Preliminary results of multilevel analyses show that the variation in prescription of lipid lowering drugs as primary prevention than as secondary prevention. Conclusions: Variation in prescription of lipid lowering drugs between practices is large. Variation is both caused by patient and GP characteristics. At the conference characteristics of GP’s that deviate from the national prescription standard (NHG) will be elucidated and ways to improve appropriateness of drug prescription will be discussed.(aut. ref.)