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Cluster-randomised trial of the Effectiveness of Quality Incentive Payments in General Practice (EQuIP-GP): Prescribing of medicines outcomes
Peterson, GM and Radford, J and Russell, G and Zwar, N and Mullan, J and Mullan, J and Batterham, M and Mazza, D and Eckermann, S and Metusela, C and Saunder, T and Kitsos, A and Bonney, A, Cluster-randomised trial of the Effectiveness of Quality Incentive Payments in General Practice (EQuIP-GP): Prescribing of medicines outcomes, Research in Social and Administrative Pharmacy pp. 1-5. ISSN 1551-7411 (2023) [Refereed Article]
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Copyright 2023 The Authors. This is an open access article under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), license, https://creativecommons.org/licenses/by-nc-nd/4.0/
Background: The Effectiveness of Quality Incentive Payments in General Practice (EQuIP-GP) study investigated whether targeted financial incentives promoting access to a preferred general practitioner, post-hospitalisation follow-up and longer consultations, increase patient-perceived relational continuity in primary care. Secondary outcomes included the use of medicines.
Objective: To evaluate whether introducing a general practice-level service model incorporating enrolment and continuous and graded quality improvement incentives influenced the total prescriptions written and potentially inappropriate prescribing of medicines.
Methods: A 12-month cluster-randomised controlled trial, whereby participating patients within intervention practices were offered enrolment with a preferred general practitioner, a minimum of three longer appointments, and review within seven days of hospital admission or emergency department attendance. Control practice patients received usual care. Differences between intervention and control groups pre-post trial for total prescriptions were analysed, as an indicator of polypharmacy, along with prescriptions for four groups of drugs known to have common quality of medicines issues: antibiotics, benzodiazepines, opioids and proton pump inhibitors (PPIs).
Results: A total of 774 patients, aged 18–65 years with a chronic illness or aged over 65 years, from 34 general practices in metropolitan, regional and rural Australia participated. The mean number of medicine prescriptions per month at baseline was 4.19 (SD 3.27) and 4.34 (SD 3.75) in the control and intervention arms, respectively, with no significant between-group differences in changes pre-post trial and also no significant between-group or within-group differences of prescription rates for antibiotics, benzodiazepines, opioids or PPIs.
Conclusions: Total prescribing volume and the use of key medicines were not influenced by quality-linked financial incentives for offering longer consultations and early post-hospital review for enrolled patients.
|Item Type:||Refereed Article|
|Keywords:||primary health care, general practice, prescribing, medications, continuity of care, financial incentives|
|Research Division:||Health Sciences|
|Research Group:||Health services and systems|
|Research Field:||Primary health care|
|Objective Group:||Provision of health and support services|
|Objective Field:||Primary care|
|UTAS Author:||Peterson, GM (Professor Gregory Peterson)|
|UTAS Author:||Radford, J (Professor Jan Radford)|
|UTAS Author:||Saunder, T (Mr Timothy Saunder)|
|UTAS Author:||Kitsos, A (Mr Alex Kitsos)|
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