The Impact Of Quality Circles On Prescribing Habits Of Gps. Results From A Prospective Controlled Study In The Area Of Magdeburg, Germany.

Szecsenvi J, Andres E, Brage Band Meyer D.
Aims and objectives. In Germany more than 70.000 medications are on the market and prescribing in general practice results in relative high costs. The aim of this study was to demonstrate how prescribing patterns of GPs could be changed in terms of cost and quality by participation in a quality circle.
Methods. 90 GPs from 97 urban and rural practices of the Magdeburg area volunteered to participate in 11 quality circle sessions of 21/2 hrs. each. The discussions were based on a detailed analysis of all prescriptions issued by each practice during a three-month period for the patients insured with a big sickness fund (AOK), and background information about the topics discussed. A group of 87 randomly selected practices from the same region was used as a control without intervention. Results. After the intervention costs of medication per patient decreased by 0.8% from the second quarter of 1996 compared with the second quarter of 1998. In the control group costs increased by 5.0%. The increase in the control group was comparable to the national figures about costs for medication over the two-year period observed. The number of medications prescribed per patient decreased by 13.5% in the intervention group and by 9.3% in the control group. An analysis of the drugs prescribed showed that on the one hand there was a general tendency to prescribe modern drug combinations for example in the treatment of peptic ulcer. On the other hand there was a substantial decrease of prescriptions issued for drugs who have questionable effects.
Conclusion. Quality circles based on an analysis of prescriptions are effective in terms of cost and quality.
The impact of quality circles on prescribing habits of GPs. Results from a prospective controlled study in the area of Magdeburg, Germany.