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Compliance with quality prescribing indicators in terms of their relationship to financial incentives

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

To develop quality prescribing indicators for general practitioners (GPs) who are non-monitored and not included in pay-for-performance programs, and to determine compliance with incentivized and non-incentivized indicators.

Study design

Descriptive cross sectional study. Setting: Aljarafe Primary Health Care Area (Andalusian Public Health Care Service, Spain), a rural and suburban area with a population of 323,857 inhabitants. Health assistance in this area is provided by 176 GPs in 37 health centers. Prescribing indicators were developed by a multidisciplinary group using a qualitative technique based on consensus. The members of the consensus group searched for updated recommendations focused on clinical evidence. Prescribing data were obtained from the computerised pharmacy records of reimbursed drugs and clinical data from the electronic clinical databases and hospital admission records.

Results

Fourteen indicators based on the selection of drugs of different therapeutic groups or linked to patient´s clinical information were designed. The compliance with indicators based on the selection of drugs linked to financial incentives was higher than that of indicators not linked to financial incentives. The compliance with indicators based on clinical information varied widely. Inappropriate prescribing ranged from 7 %, in the use of long-acting beta-agonists in asthma, to 86 % in the use of drugs for the prevention of osteoporotic fractures in young women.

Conclusions

This study shows better compliance by GPs with indirect and incentivized quality prescribing indicators, included in pay-for-performance programs, compared with not-incentivized indicators based on the relative use of drugs and on the appropriateness prescribing.

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Acknowledgements

We are grateful to the Pharmacy Department of the Andalusian Public Health Care System for their support in providing the tools to exploit prescribing indicators through the official prescribing database.

Conflict of interest

The authors declare that they have not conflicts of interest to disclose.

Ethics approval

This study has been approved by Aljarafe Primary Care Area Ethics Committee. This work complies with the current laws of the country in which it was performed.

Contributors

RFU designed and managed the project and wrote the article. MCMB, PPP and BPP provided input to the design and data interpretation. All authors have read and have approved the current version of the paper. RFU is the guarantor. The consensus group was formed by MC Montero Balosa (primary care pharmacist), C Beltrán Calvo (primary care pharmacist), R Fernández Urrusuno (primary care pharmacist), MO Caraballo Camacho (primary care pharmacist), B Pascual de la Pisa (general practitioner), J Bautista Paloma (hospital pharmacist), A Fernández Moyano (hospital practitioner) and S González Limones (primary care nurse).

Funding

This investigation was supported by The Spanish Society of Primary Care Pharmacists (SEFAP).

Author information

Authors and Affiliations

  1. Service of Pharmacy, Aljarafe-Sevilla Norte Primary Health Care Area, Distrito Sanitario Aljarafe; Avda de las Américas s/n, 41927, Mairena del Aljarafe, Seville, Spain

    Rocío Fernández Urrusuno & Ma Carmen Montero Balosa

  2. Andalucian Patient Safety Observatory, Agency for Health Care Quality, Aljarafe Primary Health Care Area, Seville, Spain

    Pastora Pérez Pérez

  3. Family and Communitary Practice, Aljarafe-Sevilla Norte Primary Health Care Area, Seville, Spain

    Beatriz Pascual de la Pisa

Authors
  1. Rocío Fernández Urrusuno
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  2. Ma Carmen Montero Balosa
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  3. Pastora Pérez Pérez
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  4. Beatriz Pascual de la Pisa
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Corresponding author

Correspondence to Rocío Fernández Urrusuno.

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Fernández Urrusuno, R., Montero Balosa, M.C., Pérez Pérez, P. et al. Compliance with quality prescribing indicators in terms of their relationship to financial incentives. Eur J Clin Pharmacol 69, 1845–1853 (2013). https://doi.org/10.1007/s00228-013-1542-4

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  • DOI: https://doi.org/10.1007/s00228-013-1542-4

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