Drug prescribing during direct and indirect contacts with patients in general practice: A report from the Møre & Romsdal Prescription Study

Abstract

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 M0re & Romsdal, the GPs recorded all contacts with patients and prescriptions during two months.

Subjects-69 843 contacts with patients (42 202 DC,-24 983 IC) during which 56 758 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.

Key Words:

• drugs
• family practice
• prescription
• prescribing
• direct
• indirect
• contact
• initial
• repeat