THE INFLUENCE OF PRACTICE CHARACTERISTICS ON THE PRESCRIBING OF BENZODIAZEPINES AND APPETITE-SUPPRESSANT DRUGS

Background - The prescribing volume of benzodiazepines and of appetite suppressant drugs have been suggested as possible indicators of presc ribing quality. Objective - To investigate the variation among general practices in the prescribing of benzodiazepines and appetite suppress ants by examining the contribution to this variation of training statu s, partnership status, fundholding status and the level of deprivation in the practice population. Methods - Prescribing data (PACT) were an alysed for 350 practices in the former Mersey Regional Health Authorit y, for the year ending March 1991 and the year ending March 1994. Data were first standardized for variation in practice population demograp hy. Multiple linear regressions were used to investigate the variation among practices in standardized prescribing volume in both years. Res ults - For benzodiazepines, training status and partnership status con tributed to all models and level of deprivation contributed to some (p ercentage of variation explained for year ending March 1991: 10% to 21 %, year ending March 1994: 8% to 20%). For appetite suppressant drugs fundholding status and an interaction between training status and leve l of deprivation contributed to all models in both years (percentage o f variation explained for year ending March 1991: 19% to 20%, year end ing March 1994: 20% to 21%). Conclusion - The prescribing of benzodiaz epines is lower in training practices, in multi-partner practices and in practices serving a less deprived population, while the prescribing of appetite suppressant drugs is lower in training practices and in f undholding practices. Variation in prescribing knowledge, organization al and management capabilities and patient demand may be explanatory f actors. (C) 1998 John Wiley & Sons, Ltd.