Prescribing indicators for UK general practice: Delphi consultation study

Objectives To identify prescribing indicators based on prescribing analysis and cost (PACT) data that have face validity for measuring quality or cost minimisation. Design Modified two round Delphi questionnaire requiring quantitative and q ualitative answers. Setting Health authorities in England. Participants All health authority, medical and pharmaceutical advisers in t he first round and lead prescribing advisers for each health authority in t he second round. Main outcome measures Face validity (median rating of 7-9 on a nine point s cale without disagreement) and reliability (rating 8 or 9) of indicators fo r assessing quality and cost minimisation. Results Completed second round questionnaires were received from 79 respond ents out of 99. The median rating was 7 for cost minimisation and 6 for qua lity, and in all except four cases individual respondents rated indicators significantly higher for cost than for quality. Of the 41 indicators tested , only seven were rated valid and reliable for cost minimisation and five f or quality. Conclusion The 12 indicators rated as valid by leading prescribing advisers had a narrow focus and would allow only a limited examination of prescribi ng at a general practice, primary care group, or health authority level.