Abstract:
OBJECTIVES:To observe one general practice's attempt to reduce prescribing costs on becoming third wave fundholders through the introduction of a generic formulary applied to all new and repeat prescribing. To assess the impact on patients and prescribing patterns. DESIGN:An observational study using interviews with patients and practitioners; questionnaires for patients and prescribing data. SETTING:One urban general practice with five partners in Scotland. It became fundholding in April 1993. SUBJECTS:71 searches of the register of repeat prescriptions identified 1274 potential changes in drugs. Questionnaires were sent to a stratified random sample of 280 patients four months after the changes were made; 33 interviews were conducted with 17 patients selected by local pharmacists to represent a wide range of opinion. MAIN OUTCOME MEASURES:Changes in prescribing and response and satisfaction of patients. RESULTS:Of intended changes, 129 (70%) were in place after four months. Thirty three (20%) of the 167 patients who returned questionnaires were "very unhappy," though interviews suggested that this was primarily with the communication they received rather than the change itself. Generic prescribing rose from one in three (37%) to over a half (58%). The volume of treatment dispensed (as treatment days) fell by 67,674 (10.7%), and the average cost per day's treatment fell by 3.1 p from 32.3 p per day in 1992 (9.4%), producing a total absolute saving of 24% (137,712 pounds) over the first year. CONCLUSION:This practice has achieved a large reduction in prescribing costs rapidly. These were tolerated by patients, none of whom is thought to have left the practice for this reason. Great care must be taken to inform patients appropriately.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Dowell JS,Snadden D,Dunbar JAdoi
10.1136/bmj.310.6978.505subject
Has Abstractpub_date
1995-02-25 00:00:00pages
505-8issue
6978eissn
0959-8138issn
1756-1833journal_volume
310pub_type
杂志文章abstract:OBJECTIVE:To report the percentage of graduates from British medical schools who eventually practise medicine in the British NHS. DESIGN:Cohort studies using postal questionnaires, employment data, and capture-recapture analysis. SETTING:Great Britain. SUBJECTS:32 430 graduates from all British medical schools in ni...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b1977
更新日期:2009-06-03 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of a monovalent rotavirus vaccine against severe rotavirus disease and to assess its impact on diarrhoea in children aged less than 2 years after national introduction in El Salvador, a low-middle income country in Central America. DESIGN:Matched case-control study. SETTING:Sev...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
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更新日期:2010-06-15 00:00:00
abstract:OBJECTIVE:To undertake a cost effectiveness analysis comparing first and second generation endometrial ablative techniques, hysterectomy, and the levonorgestrel releasing intrauterine system (Mirena) for treating heavy menstrual bleeding. DESIGN:Model based economic evaluation with data from an individual patient data...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
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更新日期:2011-04-26 00:00:00
abstract:OBJECTIVES:To develop an easily applicable diagnostic scoring method to determine the presence of peptic ulcers in dyspeptic patients in a primary care setting; to evaluate whether Helicobacter pylori testing adds value to history taking. DESIGN:Cross sectional study. SETTING:General practitioners' offices in the Utr...
journal_title:BMJ (Clinical research ed.)
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doi:10.1136/bmj.323.7304.71
更新日期:2001-07-14 00:00:00
abstract:OBJECTIVE:To study the long term risk of cervical and other cancers after treatment for cervical intraepithelial neoplasia. DESIGN:Retrospective cohort study. SETTING:University Hospital, Helsinki, Finland. PARTICIPANTS:7564 women treated for cervical intraepithelial neoplasia during 1974 and 2001 and followed up th...
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pub_type: 杂志文章
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更新日期:2005-11-19 00:00:00
abstract:OBJECTIVE:To assess the effects of social deprivation on survival after cardiac surgery and to examine the influence of potentially modifiable risk factors. DESIGN:Analysis of prospectively collected data. Prognostic models used to examine the additional effect of social deprivation on the end points. SETTING:Birming...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
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更新日期:2009-04-02 00:00:00
abstract:OBJECTIVE:To investigate the effect of two different food supplements on body mass index (BMI) in wasted Malawian adults with HIV who were starting antiretroviral therapy. DESIGN:Randomised, investigator blinded, controlled trial. SETTING:Large, public clinic associated with a referral hospital in Blantyre, Malawi. ...
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pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.b1867
更新日期:2009-05-22 00:00:00
abstract:OBJECTIVE:To assess the impact of a theoretically based sex education programme (SHARE) delivered by teachers compared with conventional education in terms of conceptions and terminations registered by the NHS. DESIGN:Follow-up of cluster randomised trial 4.5 years after intervention. SETTING:NHS records of women who...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.39014.503692.55
更新日期:2007-01-20 00:00:00
abstract:OBJECTIVE:To estimate the risk of acute hepatotoxicity associated with nimesulide compared with other non-steroidal anti-inflammatory drugs. DESIGN:Retrospective cohort and nested case-control study. SETTING:Umbria region, Italy. PARTICIPANTS:400 000 current, recent, and past users (almost 2 million prescriptions) o...
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doi:10.1136/bmj.327.7405.18
更新日期:2003-07-05 00:00:00
abstract:OBJECTIVE:To study the processes involved in and impact of mergers between NHS trusts, including the effect on management costs. DESIGN:Cross sectional study involving in depth interviews and documentary analysis; case study to compare savings in management costs between case trusts and control trusts. SETTING:Nine t...
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pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.325.7358.246
更新日期:2002-08-03 00:00:00
abstract:OBJECTIVES:To compare the effectiveness of in vitro fertilisation with single embryo transfer or in vitro fertilisation in a modified natural cycle with that of intrauterine insemination with controlled ovarian hyperstimulation in terms of a healthy child. DESIGN:Multicentre, open label, three arm, parallel group, ran...
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-01-09 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2019-12-11 00:00:00
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更新日期:2006-03-11 00:00:00
abstract:OBJECTIVE:To describe temporal trends in the time interval between first and second attempts at defibrillation and the association between this time interval and outcomes in patients with persistent ventricular tachycardia or ventricular fibrillation (VT/VF) arrest in hospital. DESIGN:Retrospective cohort study SETTI...
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doi:10.1136/bmj.i1653
更新日期:2016-04-06 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1991-08-17 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6651.757
更新日期:1988-09-24 00:00:00
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更新日期:2006-01-14 00:00:00
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更新日期:1994-02-05 00:00:00
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更新日期:1993-09-04 00:00:00
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journal_title:BMJ (Clinical research ed.)
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更新日期:2013-05-13 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.324.7332.274
更新日期:2002-02-02 00:00:00
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更新日期:2012-10-15 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
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更新日期:2008-07-31 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
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更新日期:1997-03-01 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.c1035
更新日期:2010-03-16 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:1991-02-09 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.a661
更新日期:2008-07-24 00:00:00