ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2021
Medication adherence and clinical outcomes in dispensing and non-dispensing practices: a cross-sectional analysis.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Understanding measurement of postural hypotension: a nationwide survey of general practice in England.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- General practice characteristics associated with pay-for-performance in the UK: a systematic review.BJGP open · 2025Article
- Peripheral artery disease recognition, diagnosis, and management in general practice in the Republic of Ireland and England: an online survey.BJGP open · 2024Article
- Recruitment and retention of staff in rural dispensing primary care practice: a qualitative inquiry.BJGP open · 2024Article
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5 authors.
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Abstract
backgroundMost patients obtain medications from pharmacies by prescription, but rural general practices can dispense medications. The clinical implications of this difference in drug delivery are unknown. This study hypothesised that dispensing status may be associated with better medication adherence. This could impact intermediate clinical outcomes dependent on medication adherence in, for example, hypertension or diabetes.
aimTo investigate whether dispensing status is associated with differences in achievement of Quality and Outcomes Framework (QOF) indicators that rely on medication adherence. DESIGN AND
settingCross-sectional analysis of QOF data for 7392 general practices in England.
methodQOF data from 1 April 2016 to 31 March 2017 linked to dispensing status for general practices with list sizes ≥1000 in England were analysed. QOF indicators were categorised according to whether their achievement depended on a record of prescribing only, medication adherence, or neither. Differences were estimated between dispensing and non-dispensing practices using mixed-effects logistic regression, adjusting for practice population age, sex, deprivation, list size, single-handed status, and rurality.
resultsData existed for 7392 practices; 1014 (13.7%) could dispense. Achievement was better in dispensing practices than in non-dispensing practices for seven of nine QOF indicators dependent on adherence, including blood pressure targets. Only one of ten indicators dependent on prescribing but not adherence displayed better achievement; indicators unrelated to prescribing showed a trend towards higher achievement by dispensing practices.
conclusionDispensing practices may achieve better clinical outcomes than prescribing practices. Further work is required to explore underlying mechanisms for these observations and to directly study medication adherence rates.
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