Improving medication safety: influence of a patient-specific prescriber feedback program on rate of medication reviews performed by Australian general medical practitioners

Authors

  • Elizabeth Roughead,

    1. Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5001, Australia
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  • Nicole Pratt,

    1. Data Management and Analysis Centre, Discipline of Public Health, University of Adelaide, Australia
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  • Robert Peck,

    1. Department of Veterans' Affairs, Australian Government, Australia
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  • Andrew Gilbert

    Corresponding author
    1. Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5001, Australia
    • Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
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  • The sponsor of this project had the right of final editing and/or approval of the manuscript submitted.

  • This study was approved by the Human Research Ethics Committee, University of South Australia and the Department of Veterans' Affairs Human Research Ethics Committee.

Abstract

Purpose

To determine if patient-specific prescriber feedback for general medical practitioners (GPs), supported by educational material mailed to their patients, would increase home medicines review (HMR) rates.

Methods

An observational study was conducted using the Repatriation Pharmaceutical Benefits Scheme (RPBS) Pharmacy Claims Database. The intervention group (n = 40 270) included all veterans aged ≥65 years, dispensed ≥5 unique medicines each month over a 4 month period. Comparison group veterans (n = 49,227) were those who did not have ≥5 or more unique medicines dispensed each month, but did have at least one prescription each month and ≥20 prescriptions over 4 months, of which five were unique medicines, Intervention GPs (n = 11,384) were subdivided into 2 groups: GPs with intervention veterans (n = 2097) and GPs with both intervention and comparison group veterans (n = 9287). The comparison group of GPs (n = 3630) were primary prescribers to the comparison veterans only. Rates of HMRs pre and post-intervention and the number of new GPs participating in HMR services were examined.

Results

There was a significant increase in HMR rates in intervention group, from 2.2 per 1000 in the pre-period to 4.6 per 1000 per month in the post-intervention period (Rate Ratio (RR) 2.06, 95% Confidence Interval (CI) (1.90, 2.22), p < 0.0001). HMR rates increased in the intervention group compared with the comparison group (p < 0.0001). HMR rates increased in the intervention group GPs compared with the comparison group (RR 1.79, 95% CI (1.58, 2.02), p < 0.0001).

Conclusion

Patient-specific feedback provided to GPs, supported by educational material mailed directly to their patients increased HMR rates for targeted veterans and increased GP participation in the delivery of HMRs. Copyright © Commonwealth of Australia 2007. Published by John Wiley & Sons Ltd.

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