PMID- 31378781
OWN - NLM
STAT- MEDLINE
DCOM- 20191127
LR  - 20220409
IS  - 2173-9110 (Electronic)
IS  - 1135-5727 (Linking)
VI  - 93
DP  - 2019 Aug 5
TI  - [Influential factors in the quality of prescription in primary care and relation 
      to pharmaceutical expenditure].
LID - e201908054 [pii]
AB  - OBJECTIVE: The high pharmaceutical consumption requires establishing improvement 
      measures with the collaboration of all the agents involved. The objective of the 
      study was to analyze the pharmaceutical expenditure generated by prescriptions 
      made by physicians working in a primary care area and assess its relationship 
      with the quality indicators of the prescription. METHODS: The prescriptions of 
      200 family physicians of the Basque Health Service Araba Countyand dispensed by 
      the community pharmacies between 2009 and 2016 were studied. The variables 
      evaluated retrospectively corresponded to the quality indicators of the 
      pharmaceutical prescription included in the Contract-Program of the Basque 
      Department Health of 2016. Prediction models were developed using linear 
      regression and binary logistic regression analysis. RESULTS: The main factors 
      which increased the pharmaceutical expenditure per person were: the use of novel 
      drugs which do not offer therapeutic improvements, the proportion of pensioners, 
      the use of statins and the use of antiulcer the proton pump inhibitors (PPI). On 
      the contrary, the factors that reduced this expense were: the seniority in the 
      medical position, the physician job stability and the prescription quality index. 
      The profile of the doctor who generated the greatest expense of pharmaceutical 
      prescription was mainly that of a professional who was responsible for a high 
      percentage of pensioners, prescribed a high amount of inhibitors of the enzyme 
      angiotensin converting enzyme inhibitors (ACEI), prescribed a high amount of 
      first level non-steroidal anti-inflammatory drugs (NSAIDs) and also showed high 
      use of antiulcer PPI. CONCLUSIONS: There is a statistically significant 
      correlation between physicians who generate lower pharmaceutical expenditure and 
      have a higher quality of prescription. The most influencing factors in the 
      pharmaceutical expenditure are a high percentage of pensioners in the medical 
      quota, the use of novel drugs that do not provide therapeutic improvements and 
      the prescription of statins and anti-ulcer PPI drugs.
FAU - Martinez-Gorostiaga, Javier
AU  - Martinez-Gorostiaga J
AD  - Unidad de Farmacia. Direccion de Integracion Asistencial. Organizacion Sanitaria 
      Integrada Araba. Osakidetza. Vitoria-Gasteiz (Alava). Espana.
FAU - Echevarria-Orella, Enrique
AU  - Echevarria-Orella E
AD  - Facultad de Farmacia. Departamento de Fisiologia. Universidad del Pais Vasco 
      (UPV/EHU). Cibersam. Vitoria-Gasteiz (Alava). Espana.
FAU - Calvo-Hernaez, Begona
AU  - Calvo-Hernaez B
AD  - Facultad de Farmacia. Area de Farmacia y Tecnologia Farmaceutica. Universidad del 
      Pais Vasco (UPV/EHU). Vitoria-Gasteiz (Alava). Espana.
LA  - spa
PT  - Journal Article
TT  - Factores influyentes en la calidad de la prescripcion en atencion primaria y 
      relacion con el gasto farmaceutico.
DEP - 20190805
PL  - Spain
TA  - Rev Esp Salud Publica
JT  - Revista espanola de salud publica
JID - 9600212
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Aged
MH  - Anti-Inflammatory Agents, Non-Steroidal/economics
MH  - Anti-Ulcer Agents/economics
MH  - Drug Prescriptions/*economics
MH  - Female
MH  - Health Expenditures/*standards
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/economics
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Pharmacies
MH  - Primary Health Care/economics/*standards
MH  - Proton Pump Inhibitors/economics
MH  - *Quality of Health Care
MH  - Regression Analysis
MH  - Retrospective Studies
MH  - Spain/epidemiology
OTO - NOTNLM
OT  - Pharmaceutical expenditure
OT  - Primary care
OT  - Quality of pharmaceutical prescription
OT  - Spain
OT  - Use of medicines
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2019/08/06 06:00
MHDA- 2019/11/28 06:00
CRDT- 2019/08/06 06:00
PHST- 2019/01/09 00:00 [received]
PHST- 2019/04/01 00:00 [accepted]
PHST- 2019/08/06 06:00 [entrez]
PHST- 2019/08/06 06:00 [pubmed]
PHST- 2019/11/28 06:00 [medline]
AID - e201908054 [pii]
PST - epublish
SO  - Rev Esp Salud Publica. 2019 Aug 5;93:e201908054.