SynthesisBMJ (Clinical research ed.)1996
Prevalence of potentially inappropriate long term prescribing in general practice in the United Kingdom, 1980-95: systematic literature review.
Synthesis in BMJ (Clinical research ed.), 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 15 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Developing a measure of polypharmacy appropriateness in primary care: systematic review and expert consensus study.BMC medicine · 2018Pooled it
- Frequency and Nature of Medication Errors and Adverse Drug Events in Mental Health Hospitals: a Systematic Review.Drug safety · 2017Pooled it
- Perceived difficulty and appropriateness of decision making by General Practitioners: a systematic review of scenario studies.BMC health services research · 2014Pooled it
- Combined intervention programme reduces inappropriate prescribing in elderly patients exposed to polypharmacy in primary care.European journal of clinical pharmacology · 2009Trial
- Article
- [Suitability of pharmacological treatment in patients with multiple chronic conditions].Atencion primaria · 2013Review
- Development and validation of a new Prescription Quality Index.British journal of clinical pharmacology · 2010Article
- Prevalence of inappropriate prescribing in primary care.Pharmacy world & science : PWS · 2007Article
- Reliability of a modified medication appropriateness index in primary care.European journal of clinical pharmacology · 2005Article
- Erring and learning in clinical practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2002Article
- Scope and nature of prescribing decisions made by general practitioners.Quality & safety in health care · 2002Article
- Drug interactions avoided-a useful indicator of good prescribing practice.British journal of clinical pharmacology · 2000Article
- Long-term prescribing of proton pump inhibitors in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 1999Article
- Indicators of the appropriateness of long-term prescribing in general practice in the United Kingdom: consensus development, face and content validity, feasibility, and reliability.Quality in health care : QHC · 1998Article
- Postgraduate education in clinical pharmacology and therapeutics.British journal of clinical pharmacology · 1998Review
Corrections and comments
- Erratum issued
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the prevalence of potentially inappropriate long term prescribing in general practice in the United Kingdom.
designReview of 62 studies of the appropriateness of prescribing identified from seven electronic databases, from reference lists, and by hand searching of journals. A nominal group of 10 experts helped to define the appropriateness of prescribing.
settingGeneral practice in the United Kingdom.
main outcome measuresPrevalences of 19 indicators of inappropriate long term prescribing representing five dimensions: indication, choice of drug, drug administration, communication, and review.
resultsPrevalences of potentially inappropriate prescribing varied by indicator and chronic condition, but drug dosages outside the therapeutic range consistently recorded the highest rates. The lowest rates were generally associated with indicators of the choice of the drug, except cost minimisation. Communication is studied less frequently than other dimensions of prescribing appropriateness.
conclusionsThe evidence base to support allegations of widespread inappropriate prescribing in general practice is unsound. Although inappropriate prescribing has occurred, the scale of the problem is unknown because of limitations associated with selection of a standard, publication bias, and uncertainty about the context of prescribing decisions. Opportunities for cost savings and effectiveness gains are thus unclear. Indicators applicable to individual patients could yield evidence of prescribing appropriateness.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.