Repeat prescribing: Which diagnoses,which drugs?

Background - Repeat prescribing should be limited to drugs which are to be prescribed on a long-term basis to patients whose conditions are stable. Ea rly studies were based on small sample sizes. The definition of repeat pres cribing has not been consistent and interpractice variation in repeat presc ribing has not been described. Aims - To describe the diagnostic categories and anatomical groups associat ed with repeat prescriptions; to describe interpractice variation associate d with repeat prescribing and to describe the repeat to consultation ratio for the most frequently prescribed diagnoses and drugs. Method - Doctors from a stratified quota sample of 22 Northern Ireland prac tices recorded their perceived diagnosis for every consultation and for eve ry repeat prescription over a 2-week period. Results - The diagnostic categories significantly associated with repeat pr escriptions were digestive, cardiovascular, neurological, psychiatric and m etabolic (p < 0.0001). The anatomical drug categories significantly associa ted with repeat prescriptions were gastrointestinal drugs, cardiovascular d rugs, central nervous system drugs, dressings and appliances (p < 0.0001). There was wide interpractice variation in repeat prescribing (both overall and for individual anatomical groups) and associated diagnoses. High repeat to consultation ratios were recorded for ranitidine, temazepam and diazepa n. Conclusions - Wide interpractice variation in repeat prescribing and associ ated diagnoses revealed poor consensus among practices. Therefore, the appr oach to the management of common conditions - whether to consult or issue a repeat prescription - was not uniform. The implications of these findings require further research. Commonly occurring diagnoses and drugs had unacce ptably high repeat to consultation ratios. Copyright (C) 2000 John Wiley & Sons, Ltd.