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Could repeat prescriptions identify patients needing extended medical review? An exploratory study
1National Centre for Epidemiology and Population Health, Australian National University, Canberra.
Introduction:
New Medicare Benefit Schedule care planning items require general practitioners (GPs) to identify their patients with chronic medical conditions and multidisciplinary care needs. This paper investigates the use of long term repeat prescriptions to identify general practice patients who meet these criteria.
Methods:
Twenty-nine GPs in urban, rural and inner city locations recruited 10 consecutive patients on repeat prescriptions for 12 months for medical (not primarily psychiatric) conditions. These patients reported their disease, service and morbidity (SF-36) profiles. GP attender profiles were compared with chronic disease self help group members (n = 44), an ACT community sample (n = 555) and a national GP consultation survey sample (n = 31,575).
Results:
GP patients reported common chronic disease profiles, high levels of specialist, hospital and medication usage, with infrequent use of allied health professionals and self help groups. They reported considerable physical and psychosocial morbidity comparable to or worse than other groups.
Discussion:
GP patients requesting repeat prescriptions may have substantial physical, psychological and social needs that might be met using a multidisciplinary team approach with allied health professionals and self help groups.
Conclusion:
GPs can use long term repeat prescriptions to identify a chronic disease cohort who could benefit from health care planning under the new Medicare Benefit Schedule funding arrangements.