ArticleBMJ (Clinical research ed.)1995
Use of vitamin B-12 in Leicestershire practices: a single topic audit led by a medical audit advisory group.
Article in BMJ (Clinical research ed.), 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency.The Cochrane database of systematic reviews · 2005Pooled it
- Features of primary care associated with variations in process and outcome of care of people with diabetes.The British journal of general practice : the journal of the Royal College of General Practitioners · 2001Article
- Clinical governance for diabetes in primary care: use of practice guidelines and participation in multi-practice audit.The British journal of general practice : the journal of the Royal College of General Practitioners · 2000Article
- Use of vitamin B12 injections among elderly patients by primary care practitioners in Ontario.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 1999Article
- Goals and methods of audit should be reappraised. Evidence of effectiveness of audit in improving care is growing.BMJ (Clinical research ed.) · 1996Article
- Factors influencing participation in audit.BMJ (Clinical research ed.) · 1995Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo encourage active participation of Leicestershire general practitioners and their staff in audit; to examine the use of vitamin B-12 injections and to achieve a more appropriate use.
designImplementation of an agreed audit protocol, with central analysis and feedback of anonymous and aggregated data by a medical audit advisory group.
settingAll 147 Leicestershire practices.
main outcome measuresParticipation in the complete audit cycle, comparison of actual use of vitamin B-12 injections with agreed criteria of use, and assessment of improvement in use.
results264 general practitioners (55% of all doctors from 49% of all Leicestershire practices) completed both phases of the audit cycle, and 321 (67%) completed phase 1 only. Twenty four (16%) practices failed to participate from the outset, and a further 58 (35%) dropped out at various stages. Only 10 of the 37 singlehanded practices completed the audit, although 34 initially agreed to participate. If singlehanded practices were excluded, 56% (61) of practices completed both phases of the audit cycle. In total 1714 patients received B-12 injections. Appropriate use increased from 62% in phase 1 to 72% in phase 2 of the audit; there was a 32% reduction in the number of patients inappropriately receiving B-12 (521 to 352), and the proportion of patients receiving B-12 at the correct frequency rose from 58% to 72%. The proportion of patients in whom all the diagnostic criteria for pernicious anaemia were established before treatment with B-12 was 27% in phase 1 and 28% in phase 2.
conclusionOur study suggests that single topic audits organised by a medical audit advisory group can encourage large numbers of general practitioners to participate and can bring about changes in behaviour resulting in improvements in standards of care. Nevertheless, advisory groups will need to devise strategies to encourage even higher levels of involvement, most particularly from singlehanded practices.
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