The Nelson Prescribing Project. A programmed intervention in general practice in New Zealand

We have defined the effect and acceptability of a locally developed general practice programme for the modification of prescribing. This voluntary programme consisted of prescription analysis and feedback, followed by visits from a pharmacist, a therapeutic bulletin on benzodiazepine prescribing, and use of a locally compiled preferred medicines list. A 3-month prescription sample from 26 general practitioners (GPs) fulfilling a stable practice definition was used to compare prescribing pre-project and mid-project. For 20 out of 26 GPs, prescribing of medicines on the preferred medicines list had increased significantly 8 months after the intervention programme had been introduced. Total prescription numbers and total medicines expenditure decreased by 8.3 and 4.9%, respectively, from 1988 to 1989. The decrease in benzodiazepine prescribing was marked (mean -22.2%, range -50.3 to +4%). The cooperative multimodel approach was highly successful in modifying prescribing in general practice.