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Published on: June 11, 2012
Variation in formulary adherence in general practice over time (2003-2007).
Liset van Dijk1, Judith D de Jong, Gert P Westert
1NIVEL, Netherlands Institute for Health Services Research, Utrecht. l.vandijk@nivel.nl
Family Practice
|July 27, 2011
Summary
Formulary adherence in Dutch general practice remained stable between 2003-2007, with 73-76% of prescriptions following national guidelines. Adherence varied by diagnosis and patient, but interpractice variation was constant.
Area of Science:
- General Practice
- Health Services Research
- Pharmacoeconomics
Background:
- National formularies guide evidence-based prescribing in primary care.
- Monitoring adherence to these guidelines is crucial for quality assessment.
- Understanding trends and variations in adherence informs healthcare policy.
Purpose of the Study:
- To analyze trends and variations in adherence to the Dutch national formulary.
- To examine adherence for the 20 most prevalent health problems in general practice.
- To assess adherence over a 5-year period (2003-2007).
Main Methods:
- Utilized electronic medical records from 115 general practices.
- Linked records to the national formulary, analyzing over 2 million prescriptions.
- Employed three-level multilevel logistic regression to analyze trends and variations.
Main Results:
- Formulary adherence ranged from 73-76% between 2003 and 2007.
- Adherence rates varied significantly across different health conditions.
- Lowest adherence was observed for acute bronchitis and upper respiratory infections.
Conclusions:
- General practice information networks effectively monitor formulary adherence.
- Adherence is stable over time but shows variation across diagnoses, patients, and practices.
- Efforts to increase formulary adherence have stabilized prescribing patterns despite external influences.
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