Should the corticosteroid to bronchodilator ratio be promoted as a quality prescribing marker?

Abstract:

:In recent years the ratio of inhaled corticosteroid:bronchodilator (C:B) prescribing has been promoted as a quality marker for asthma treatment and cross-sectional data indicate an association with hospital admissions. If prescribing advice has been followed then it can be hypothesised that the C:B ratio will have increased and hospitalisation decreased. The West Midlands General Practice Research Database was used to monitor changes in the C:B ratio and hospital referrals for asthma between 1993 and 1996. The C:B ratio increased from 0.5 to 0.6 (P<0.001) and hospital referrals decreased from 7% to 4% per annum (P<0.001). Overall, 38% of the variation in hospital referrals was explained by the C:B ratio. This is higher than previous studies, perhaps because the study was longitudinal and the ratio assessed accurately in terms of volume rather than prescription items. When measured in defined daily doses, the C:B ratio does appear to have validity as an indicator of good prescribing in primary care. The General Practice Research Database offers an opportunity for assessing the validity of prescribing indicators before they are considered for wider use by Primary Care Groups and Health Authorities.

journal_name

Public Health

journal_title

Public health

authors

Frischer M,Heatlie H,Chapman S,Norwood J,Bashford J,Millson D

doi

10.1038/sj.ph.1900583

subject

Has Abstract

pub_date

1999-09-01 00:00:00

pages

247-50

issue

5

eissn

0033-3506

issn

1476-5616

pii

S0033-3506(99)00168-7

journal_volume

113

pub_type

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