This study estimates the impact of patient financial incentives on the use and cost of prescription drugs in the context of differing physician payment mechanisms. A large data set was developed that covers persons in managed care who pay varying levels of cost sharing and whose physicians are compensated under two different models: independent practice association (IPA)-model and network-model...

BACKGROUND General Practitioners (GPs) are well placed to care for patients with (chronic) substance use problems. This pilot was carried out to study the feasibility and usefulness of a continuous surveillance of substance use problems among general practice patients. The objectives were (i) to describe variables with missing values exceeding 1% and whether patients were reported without subst...

OBJECTIVE To analyse sex differences among recipients of benzodiazepines in Dutch general practice. DESIGN Study of consultations and associated interventions as recorded in the Dutch national survey of general practice. SETTING Practices of 45 general practitioners monitored during 1 April to 30 June 1987. SUBJECTS 61,249 patients (29,035 (47.4%) men in the age groups 19-44, 45-64, and 6...

BACKGROUND Medication-overuse headache (MOH) is common in the general population, and most patients are managed in primary health care. Brief Intervention (BI) has been used as a motivational technique for patients with drug and alcohol overuse, and may a have role in the treatment of MOH. AIM To explore GPs' experiences using BI in the management of patients with MOH. DESIGN AND SETTING Qu...

BACKGROUND The incidence of self-reported acute gastrointestinal illness (AGI) in Rigolet, Nunatsiavut, and Iqaluit, Nunavut, is higher than reported elsewhere in Canada; as such, understanding AGI-related healthcare use is important for healthcare provision, public health practice and surveillance of AGI. OBJECTIVES This study described symptoms, severity and duration of self-reported AGI in...

OBJECTIVE To investigate a method of assessing the extent of routine patient data held on computer by Scottish general practitioners. DESIGN An "electronic questionnaire" in the form of an interrogation questionnaire was used to extract a subset of data from practice computers running a standard software package (the general practice administrative system for Scotland, GPASS). The data were r...

BACKGROUND Antibiotic consumption is associated with adverse drug events (ADE) and increasing antibiotic resistance. Detailed information of antibiotic prescribing in different age categories is scarce, but necessary to develop strategies for prudent antibiotic use. The aim of this study was to determine the antibiotic prescriptions of different antibiotic classes in general practice in relatio...

In Jamaica, the 1993 amendment to the Pharmacy Act allows pharmacists to offer patients generic substitutions for innovator brands; however, there were reservations among physicians about this policy implementation. The success of the amendment may be influenced by the confidence of physicians in the therapeutic equivalence of generics, especially since the act also allows physicians to indicat...

About 1% of patients in general practice take antidepressants for long periods. Many receive repeat prescriptions, without review. It might be assumed that these patients are well and are on adequate maintenance treatment. Our findings refute this assumption; of 78 patients on long-term repeats, only a third were in remission and a fifth had Beck Depression Inventory scores suggesting persistin...

OBJECTIVE The efficacy of programmes to reduce long-term benzodiazepine use could be compromised by subsequent increases in contacts with the family practice. In this study the hypothesis was tested as to whether participation in a benzodiazepine discontinuation programme affects the frequency of contacts with the family practice. DESIGN A controlled stepped-care intervention programme to dec...