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Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

The scale of repeat prescribing – time for an update

Authors: Duncan R Petty, Arnold G Zermansky, David P Alldred

Published in: BMC Health Services Research | Issue 1/2014

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Abstract

Background

The NHS spends billions of pounds annually on repeat prescriptions in primary care, but data on their extent and use is out of date. Understanding the scale of repeat prescribing and for whom it is prescribed is important for the NHS to plan services and develop policies to improve patient care.

Method

Anonymous data on prescription numbers and practice population demographics was obtained from GP computer systems in a large urban area.
Searches were conducted in November 2011 to identify the numbers of repeat items listed on individuals’ repeat lists by sex and age.
The proportion of all prescription items issued as repeats was identified by conducting searches on items issued as repeat and acute prescriptions.

Results

In the year of study 4,453,225 items were issued of which 3,444,769 (77%) were repeats (mean 13 items per patient/annum) and 1,008,456 (23%) acute prescriptions (mean 3.9 items per patient per annum). The mean number of repeat Items per patient was 1.87 (range 0.45 ages 0-9 years; 7.1 ages 80-89 years). At least one repeat medicine was prescribed to 43% of the population (range 20% for ages 0-9; over 75% for ages 60+).

Conclusion

A significant proportion of the population receive repeat prescriptions and the proportion increases with age. Whilst the proportion of repeat items to acute items has remained unchanged over the last two decades the number of repeat prescriptions items issued has doubled (from 5.8 to 13.3 items/patient/annum). This has implications for general practice workload, patient convenience, NHS costs and risk.
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Literature
1.
go back to reference Swinglehurst D, Greenhalgh T, Russell J, Myall M: Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study. BMJ. 2011, doi:10.1136/bmj.d6788 Swinglehurst D, Greenhalgh T, Russell J, Myall M: Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study. BMJ. 2011, doi:10.1136/bmj.d6788
2.
go back to reference Duerden M, Millson D, Avery A, Smart S: The quality of GP prescribing: an inquiry into the quality of general practice prescribing in England. 2011, London: The King's Fund Duerden M, Millson D, Avery A, Smart S: The quality of GP prescribing: an inquiry into the quality of general practice prescribing in England. 2011, London: The King's Fund
3.
go back to reference Avery AJ: Repeat prescribing in general practice. BMJ. 2011, doi:10.1136/bmj.d7089 Avery AJ: Repeat prescribing in general practice. BMJ. 2011, doi:10.1136/bmj.d7089
6.
go back to reference White KG: UK interventions to control medicines wastage: a critical review. IJPP. 2010, 18: 131-140. White KG: UK interventions to control medicines wastage: a critical review. IJPP. 2010, 18: 131-140.
7.
go back to reference Davies JE, Taylor DG: Individualisation or standardisation trends in National Health Service prescription durations in England 1998-2009. Prim Health Care Res Dev. 2013, 14: 164-174. 10.1017/S146342361200045X.CrossRefPubMed Davies JE, Taylor DG: Individualisation or standardisation trends in National Health Service prescription durations in England 1998-2009. Prim Health Care Res Dev. 2013, 14: 164-174. 10.1017/S146342361200045X.CrossRefPubMed
8.
go back to reference Wilson PM, Kataria N, McNeilly E: Patient and carer experience of obtaining regular prescribed medication for chronic disease in the English National Health Service: a qualitative study. BMC Health Serv Res. 2013, 13: 192-10.1186/1472-6963-13-192.CrossRefPubMedPubMedCentral Wilson PM, Kataria N, McNeilly E: Patient and carer experience of obtaining regular prescribed medication for chronic disease in the English National Health Service: a qualitative study. BMC Health Serv Res. 2013, 13: 192-10.1186/1472-6963-13-192.CrossRefPubMedPubMedCentral
9.
go back to reference Roberts S, Harris C: Age, sex and temporary resident originated prescribing units (ASTRO-PUs): new weightings for analysing prescribing of general practices in England. BMJ. 1993, 307: 485-488. 10.1136/bmj.307.6902.485.CrossRefPubMedPubMedCentral Roberts S, Harris C: Age, sex and temporary resident originated prescribing units (ASTRO-PUs): new weightings for analysing prescribing of general practices in England. BMJ. 1993, 307: 485-488. 10.1136/bmj.307.6902.485.CrossRefPubMedPubMedCentral
10.
go back to reference Whynes DK, Baines D, Tolley KH: Explaining variations in general practice prescribing costs per ASTRO-PU (age, sex, and temporary resident prescribing unit). BMJ. 1996, 312: 488-10.1136/bmj.312.7029.488.CrossRefPubMedPubMedCentral Whynes DK, Baines D, Tolley KH: Explaining variations in general practice prescribing costs per ASTRO-PU (age, sex, and temporary resident prescribing unit). BMJ. 1996, 312: 488-10.1136/bmj.312.7029.488.CrossRefPubMedPubMedCentral
11.
go back to reference Rice N, Dixon P, Lloyd D, Roberts D: Derivation of a needs based capitation formula for allocating prescribing budgets to health authorities and primary care groups in England: regression analysis Commentary: The emphasis on transparency weakens the formula. BMJ. 2000, 320: 284-10.1136/bmj.320.7230.284.CrossRefPubMedPubMedCentral Rice N, Dixon P, Lloyd D, Roberts D: Derivation of a needs based capitation formula for allocating prescribing budgets to health authorities and primary care groups in England: regression analysis Commentary: The emphasis on transparency weakens the formula. BMJ. 2000, 320: 284-10.1136/bmj.320.7230.284.CrossRefPubMedPubMedCentral
14.
go back to reference Howard R, Avery AJ, Howard P, Partridge M: Investigation into the reasons for preventable drug related admissions to a medical admissions unit: observational study. Qual Saf Health Care. 2003, 12 (4): 280-285. 10.1136/qhc.12.4.280.CrossRefPubMedPubMedCentral Howard R, Avery AJ, Howard P, Partridge M: Investigation into the reasons for preventable drug related admissions to a medical admissions unit: observational study. Qual Saf Health Care. 2003, 12 (4): 280-285. 10.1136/qhc.12.4.280.CrossRefPubMedPubMedCentral
15.
go back to reference Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, Farrar K, Park BK, Breckenridge AM: Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ. 2004, 329: 15-19. 10.1136/bmj.329.7456.15.CrossRefPubMedPubMedCentral Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, Farrar K, Park BK, Breckenridge AM: Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ. 2004, 329: 15-19. 10.1136/bmj.329.7456.15.CrossRefPubMedPubMedCentral
17.
go back to reference Avery AJ, Ghaleb M, Barber N, Dean Franklin B, Armstrong J, Serumaga B, Dhillon S, Freyer A, Howard R, Talabi O, Mehta R: The prevalence and nature of prescribing and monitoring errors in UK general practice- a retrospective case note review. Br J Gen Pract. 2013, 63 (613): e543-e553. 10.3399/bjgp13X670679. 11CrossRefPubMedPubMedCentral Avery AJ, Ghaleb M, Barber N, Dean Franklin B, Armstrong J, Serumaga B, Dhillon S, Freyer A, Howard R, Talabi O, Mehta R: The prevalence and nature of prescribing and monitoring errors in UK general practice- a retrospective case note review. Br J Gen Pract. 2013, 63 (613): e543-e553. 10.3399/bjgp13X670679. 11CrossRefPubMedPubMedCentral
Metadata
Title
The scale of repeat prescribing – time for an update
Authors
Duncan R Petty
Arnold G Zermansky
David P Alldred
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-76

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