Seleccion de indicadores para evaluar la adhesion a una guia farmacoterapeutica por los medicos generales de un area de atencion primaria

Abstract

Background: The constant gauging of drug prescription quality is part of the health-care process quality improvement programs as regards Primary Care, but, generally speaking, there are no tried and true indicators which can be used in this assessment process. Measuring the degree to which certain set drugs are adhered to as a district-wide guide regarding which a consensus of opinion has been reached can be used as an overall indicator of prescribing- related quality. The objective of this study is that of setting out a method for selecting quality indicators of a generalizing type, the same serving as an example with regard to selecting an indicator for gauging the degree to which the district guide is followed. Methods: Descriptive cross-sectional study entailing the general practitioners in the Health Care District of Aviles (n=78) as the individual district analyzed, and the prescriptions written thereby which were invoiced in 1997 as the data source. Seven (7) indicators were prepared for gauging the degree to which the District Drug Therapy Guide was followed. A selection was made by studying the following aspects: reliability, ready availability, accuracy, sensitivity, specificity and coherence. Results: The scores fell within the 10-23 range (out of a possible 28), the highest score being that of the percentage of prescriptions for active ingredients out of the guide in comparison to the total number of prescriptions written by each physician. Conclusions: The indicators used in assessing drug-prescribing quality must first be analyzed in detail before being implemented. An innovative method is suggested for testing indicators for monitoring the prescribing of drugs as a whole. The most useful of all of the indicators studied for gauging the degree to which the Primary Care drug therapy guide was being followed is the percentage of prescriptions written for active ingredients out of the total number of prescriptions written. The degree to which the District Drug Therapy Guide is followed is related positively to quality prescribing.