Drug prescribing during direct and indirect contacts with patients in general practice: A report from the Møre & Romsdal Prescription Study
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OBJECTIVE: To describe general practitioners' (GPs) prescribing patterns during direct contacts (DC) vs. indirect contacts (IC) with respect to the patients (age and sex), diagnoses, and drugs. DESIGN: Descriptive study. SETTING: In the Norwegian county Møre & Romsdal, the GPs recorded all contacts with patients and prescriptions during two months. SUBJECTS: 69843 contacts with patients (42202 DC; 24983 IC) during which 56758 prescriptions were issued. MAIN OUTCOME MEASURES: Prescriptions (drugs, strength of tablets, amount prescribed, initial/repeat). Diagnoses for prescribing. RESULTS: 72 drugs were prescribed per 100 DC; 93 per 100 IC. The drugs prescribed most frequently during DC were CNS-drugs (19%), antibiotics (18%), and respiratory drugs (14%); and during IC, CNS-drugs (34%), cardiovascular (16%), and respiratory drugs (12%). More prescriptions during IC were repeat (IC, 79%; DC, 37%). 57% of all CNS-drugs were issued during IC (90% of which were repeat prescriptions). 25% of the antibiotics were issued during IC (70% of which were initial prescriptions). CONCLUSION: The GPs' prescribing patterns during DC and IC are different, which probably reflects that different health problems are handled during DC and IC. Prescription studies should address both settings. Our findings raise concern about the medical foundation for antibiotic and psychotropic prescribing during IC.
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Rokstad and Straand 1997 reported that antibiotic-prescribing rate was lower in remote consultations; 7.8% of remote prescriptions were antibiotics versus 17.8% of face-to-face prescriptions.
“Intervention: 43.5% of all prescriptions; 7.8% of remote prescriptions were antibiotics Control: 56.6% of all prescriptions; 17.8% of face-to-face prescriptions were antibiotics”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [20]
Four included studies lacked adjustment for any confounding factors.
“Additionally, 4 studies lacked adjustment for any confounding factors [16,18,20,23].”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [20]
The results of Rokstad and Straand and Ewen et al do not consider multiple prescriptions made in one consultation.
“However, their results do not consider multiple prescriptions made in one consultation.”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [20]
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References 17 · Cited by 17
Research works printed but not linked: 4
- Haaijer-Ruskamp FM, Stewart R, Wesseling H. Does in- direct consultation lead to overprescribing in general prac- tice? Soc Sci Med 1987;25:43-6.
- Comgan 01. A survey of medical consultation and pre- scribing rates in Ireland. Irish Pharmacy Journal 1994;62:204-8.
- Holm M. Psykofarmakaordination i almen praksis. 3. (Pre- scribing of psychopharmaceuticals in general practice. 3). English summary. Ugeskr Lzger 1989;151:2130-3.
- Dnuy VWM. Repeat prescribing -a review. J R Coll Gen 21. Balint M, Hart J, Joyce D, Marinker M, Woodcock J. Treatment and diagnosis: a study of repeat prescriptions in general practice. London: Tavistock Publications, 1970.
- Authors
- Rokstad, K., & Straand, J.
- Affiliations
- University of Bergen (NO)
- ORCID
- Straand, JØRund
- Venue
- Scandinavian Journal of Primary Health Care
- Publisher
- Informa UK Limited
- Published
- 1997-01
- Volume
- 15
- Issue
- 2
- Pages
- 103-108
- ISSN
- 0281-3432 (ISSN-L)
- 1502-7724
- OpenAlex
- W2074845747
- Cited by
- 17
- References
- 17
- Citations by year
- 2024: 1 · 2021: 1 · 2020: 1 · 2018: 1 · 2016: 1 · 2014: 1 · 2013: 1
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Scandinavian Journal of Primary Health Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Keywords
- prescribing patterns, general practitioners, direct patient contact, repeat prescriptions, central nervous system drugs, psychotropic drugs, antibiotics, respiratory drugs, cardiovascular drugs
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Drug Utilization, Family Practice, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Norway, Office Visits, Practice Patterns, Physicians', Telephone, Confidence Intervals
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