ABSTRACT
Objetivo. Determinar el porcentaje de nuevas prescripciones procedentes de Atención Especializada recibidas y modificadas por los médicos de Atención Primaria. Diseño. Estudio descriptivo, transversal y multicéntrico con la participación durante 2 meses de médicos de Atención Primaria de un área de salud de Madrid. Se estableció una metodología de registro del origen de las nuevas prescripciones en la historia clínica informatizada. Para registrar las prescripciones sin cambios respecto a las procedentes de Atención Especializada se marcaba la opción «segundo nivel» al emitir la receta. Se elaboró un protocolo disponible en la historia clínica informatizada para cuando, existiendo una nueva prescripción de Atención Especializada, el médico de primaria no realizara ninguna prescripción o emitiera una receta con modificaciones respecto a la original. Resultados. Un total de 69 médicos de 15 centros de salud registraron 46.512 nuevas prescripciones, 3.893 (8,4%) procedentes de Atención Especializada. De estas últimas, en el ámbito de Atención Primaria fueron asumidas sin cambios 3.544 (91,0% IC95%: 90,1-91,9), se modificaron 298 (7,7% IC95%: 7,0-8,7) y no se realizó ninguna prescripción en 46 ocasiones (1,2% IC95%: 0,8-1,5). El 51% de los médicos modificó alguna prescripción, siendo la mediana de prescripciones cambiadas o no emitidas de 3. La principal causa de modificación fue la sustitución por genéricos. Conclusiones. Las nuevas prescripciones procedentes de Atención Especializada son asumidas sin cambios en un alto porcentaje por los médicos de Atención Primaria. Los cambios se concentran en la mitad de los médicos participantes, sugiriendo que esta práctica no se asume de forma generalizada por los profesionales(AU)
Objective. To determine the percentage of new Specialist Healthcare prescriptions received and modified by Primary Healthcare physicians. Design. Descriptive, cross-sectional and multi-centre study with the participation of Primary Healthcare physicians from one Madrid Health Area during 2 months. A method was established for registering the origin of the new prescriptions in the Computerised Medical Record System. In order to register new prescriptions without any change from Specialist Healthcare, the «second level» option was marked when the prescription was issued. A protocol was prepared and was available on the Computerized Medical Record System, so for those cases where there was a new Specialist Healthcare prescription, the Primary Healthcare physician would not issue any prescription or issue a prescription with changes as regards the original one. Results. A total of 69 Primary Healthcare physicians from 15 Primary Healthcare centres registered 46,512 new prescriptions, 3,893 (8.4%) from Specialist Healthcare. From this number, 3,544 prescriptions (91.0% 95% CI: 90.1-91.9) were issued without changes, and 298 prescriptions were modified (7.7% 95% CI: 7.0-8.7). In 46 cases (1.2% 95% CI: 0.8-1.5) no prescription was issued. Some prescriptions were changed by 51% of Primary Healthcare physicians, and the median of prescriptions changed or not issued was 3. The main reason for the modification was replacement with generics. Conclusions. A high percentage of new Specialist Healthcare prescriptions are issued without any changes being made by Primary Healthcare physicians. Modifications are concentrated in half of the participating physicians. Therefore, these data suggest that this practice is not generally adopted by the professionals(AU)
Subject(s)
Humans , Male , Female , Primary Health Care/methods , Drug Prescriptions/standards , Medical Records/standards , Quality of Health Care/organization & administration , Quality of Health Care/standards , Electronic Health Records/standards , Electronic Health Records , Insurance, Pharmaceutical Services/ethics , Insurance, Pharmaceutical Services/trends , Primary Health Care/organization & administration , Primary Health Care/standards , Cross-Sectional Studies/methods , Cross-Sectional Studies/standards , Quality of Health Care , Electronic Health Records/legislation & jurisprudence , Electronic Health Records/organization & administration , Electronic Health Records/trendsABSTRACT
OBJECTIVE: To determine the percentage of new Specialist Healthcare prescriptions received and modified by Primary Healthcare physicians. DESIGN: Descriptive, cross-sectional and multi-centre study with the participation of Primary Healthcare physicians from one Madrid Health Area during 2 months. A method was established for registering the origin of the new prescriptions in the Computerised Medical Record System. In order to register new prescriptions without any change from Specialist Healthcare, the «second level¼ option was marked when the prescription was issued. A protocol was prepared and was available on the Computerized Medical Record System, so for those cases where there was a new Specialist Healthcare prescription, the Primary Healthcare physician would not issue any prescription or issue a prescription with changes as regards the original one. RESULTS: A total of 69 Primary Healthcare physicians from 15 Primary Healthcare centres registered 46,512 new prescriptions, 3,893 (8.4%) from Specialist Healthcare. From this number, 3,544 prescriptions (91.0% 95% CI: 90.1-91.9) were issued without changes, and 298 prescriptions were modified (7.7% 95% CI: 7.0-8.7). In 46 cases (1.2% 95% CI: 0.8-1.5) no prescription was issued. Some prescriptions were changed by 51% of Primary Healthcare physicians, and the median of prescriptions changed or not issued was 3. The main reason for the modification was replacement with generics. CONCLUSIONS: A high percentage of new Specialist Healthcare prescriptions are issued without any changes being made by Primary Healthcare physicians. Modifications are concentrated in half of the participating physicians. Therefore, these data suggest that this practice is not generally adopted by the professionals.
