Personal formularies in general practice to support safe, effective and cost-effective prescribing.

The use of personal formularies of safe, effective medicines that a prescriber is readily familiar with may enhance the quality of prescribing. Additionally, there is evidence that audit and feedback can lead to improvements in prescribing.  The Drug Utilisation 90% (DU90%), (the number of medicines making up 90% of a doctor’s prescribing, thus representing their personal formulary), is a simple and flexible tool that has previously been used as a prescribing quality indicator.

The aim of this research is to explore the current use of personal formularies in general practices using the DU90% indicator, how this relates to the quality of prescribing and how feedback using this information can be delivered to prescribers with the goal of enhancing safe and effective prescribing.

Work package (WP) 1 will include a systematic review of the effectiveness of interactive dashboards on prescribing outcomes. We’ll conduct a stakeholder analysis with patients, carers, GPs, pharmacists and policy-makers to elicit perceptions around using audit and feedback of GP practice level prescribing indicators. A data extraction tool will be developed that will allow GPs to extract anonymous prescription data and aggregate practice demographic profiles.

In WP2, approximately 85 practices throughout Ireland will be recruited and utilise the tool to export prescription data. The DU90% for individual practices and prescribers will be calculated and the association between the DU90% and low quality prescribing quality indicators (LQPI), will be assessed.

In WP3, an interactive web platform will be developed, where data analysed in WP2 will be graphically presented to GPs. Interaction with the web platform will be assessed using Google Analytics. A sample of GPs from practices involved in WP2 will be recruited to a qualitative study where the usability and acceptability of the web platform will be assessed.

Award Date: 22 September 2023
Award Value: €381,210.00
Principal Investigator: Dr Caroline McCarthy
Host Institution: Royal College of Surgeons in Ireland
Scheme: HRB Postdoctoral Fellowships: CSF 2023