GENERAL-PRACTITIONERS FOR RATIONAL USE OF DRUGS - EXAMPLES FROM SWEDEN

In the south west region of Stockholm a group of 125 general practitio ners (GPs) at 27 health centres asked about the extent to which the dr ug formulary of the University Hospital was useful in their practices. To answer this question, the GPs asked their local pharmacies for pre scribing data. When presented this started a process towards rational prescribing from within the group of GPs, including repeated prescribi ng surveys, starting with health centres as the unit of analysis and p roceeding to individual prescribing analyses on request by the GPs. As the prescribing data revealed major differences between health centre s, the GPs arranged two workshops on drug use in primary health care. They developed a list of 167 recommended drugs based on drug statistic s and morbidity in general practice. Signs of increased cost cautiousn ess could be shown. There was a clear trend towards both smaller volum es and cost per prescription item for the health centres in the study area. Compared to the national prescribing pattern, prescribing practi ce in the study area represented a 20 per cent lower drug cost. Althou gh the GPs decided on a drug list separate from that of the hospital, collaboration between the Drug and Therapeutic Committee at the hospit al and the GPs in creased as a result of their increased engagement in drug management, thereby also bridging the gap between primary health care and clinical pharmacology.