General practitioners' awareness of their own drug prescribing profiles after postal feedback and outreach visits

BACKGROUND General practice accounts for the vast majority of drug prescribing in the Nordic countries. Various methods have been used to promote rational drug prescribing. Awareness of own prescribing profile may be a first crucial step in the quality assessment and improvement process. AIM OF THE STUDY To analyse awareness among general practitioners of their drug prescribing profile during two outreach visits one year apart. METHODS All 94 practices with a total of 166 general practitioners in the former Storstrøm County, Denmark, were invited to participate in a project launching outreach visits led by a general practitioner; 88 practices with 160 general practitioners agreed to participate. RESULTS During the first round of outreach visits the general practitioners were asked to rate their own prescribing level of 13 major drug groups as being in the lowest 25%, the middle 26%-74%, or the highest 25% of the distribution across all 88 practices. The result was better than chance (chi-square = 337, 4 df, r = 0.37, both P < 0.0001). After the assessment a one-hour discussion on rational drug prescribing was held. One year later a new round of outreach visits was held. This time the assessment accuracy was generally greatly improved (chi-square = 724, 4 df, r = 0.48, both P < 0.0001). The main determinants for the improved accuracy during the second round were high accuracy during the first round, and the number of general practitioners in the practice. CONCLUSIONS General practitioners' awareness of their prescribing volumes was substantially improved by a single outreach visit with discussion on rational drug prescribing.