Description:
<jats:title>Abstract</jats:title><jats:p>It is known that traditional lecturing hardly ever leads to improvement in either the quality or cost‐effectiveness of everyday prescribing.</jats:p><jats:p>In order, therefore, to improve their prescribing behaviour a group of physicians met to assess their prescribing routine for the second quarter of 1989. These discussions highlighted prescribing problems and allowed the development of pharmacotherapy guidelines tailored to the treatment situation which presents in primary health care practice. The prescription audit and review process was repeated so that the first comparison was between 1989 and 1990 and the second between 1989 and 1991.</jats:p><jats:p>The study group consisted of 11 primary health care physicians and two advisors — one with a background in pharmacotherapy and the other with experience of group dynamics. The group met six times a year for two years. In undertaking the evaluations and comparisons special attention was paid to those drug groups in which the prescribed quantities suggested the possibility of irrational prescribing.</jats:p><jats:p>Thus, the following problem areas were discussed and evaluated:<jats:list list-type="explicit-label">
<jats:list-item><jats:p>Prescribing of drugs of which the efficacy is not proven (e.g. drugs to enhance blood flow).</jats:p></jats:list-item>
<jats:list-item><jats:p>Prescribing psychotiopic drugs in combination.</jats:p></jats:list-item>
<jats:list-item><jats:p>Unnecessary prescribing of effective drugs (e.g. benzodiazepines, and H<jats:sub>2</jats:sub> antagonists)</jats:p></jats:list-item>
<jats:list-item><jats:p>Excessively frequent prescribing in the elderly.</jats:p></jats:list-item>
<jats:list-item><jats:p>The cost‐effectiveness and usefulness of the review group process was also assessed.</jats:p></jats:list-item>
</jats:list></jats:p><jats:p>It was found that in the course of a quarter of a year the 11 physicians treated 12,800 patients. In the first year of review (1989/1990) they saved 1,152,000 DM taking the four quarters together. In the second year the savings amounted to 1,381,000 DM. These savings were mainly the result of reduced prescription frequency and it was noted that the prescribing of less expensive drugs had only a minor effect.</jats:p>