Clayton, R, Vadher, N, White, S and Chapman, S (2018) An evaluation of paracetamol and ibuprofen prescribing at three high-spend GP practices in Sandwell and West Birmingham: A prescribing analysis study. Pharmacoepidemiology and Drug Safety, 27. S7 -S7.

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Abstract

Background
Paracetamol and ibuprofen are readily available without prescription for relief of pain and pyrexia caused by minor, self-limiting conditions. This study was part of Sandwell and West Birmingham Clinical Commissioning Group’s approach to promoting self-care and reducing the use of GP appointments for such conditions.

Aim
The study aimed to identify the three GP practices in the CCG with the highest spend on paracetamol and ibuprofen, and determine what indications they were prescribed for and whether the patients would have been eligible for supply under the local minor ailment scheme ‘Pharmacy First’.

Methods
The electronic Prescribing Analysis Cost Tabulation (ePACT) system was used to identify the 3 GP practices in the CCG with the highest spend and number of items per 1,000 Age, Sex and Temporary Resident Originated Prescribing Unit (ASTRO-PU) for paracetamol and ibuprofen (all forms included). For each practice, 40 patients prescribed paracetamol or ibuprofen for an acute condition between August and November 2016 were randomly selected using SystmOne. For each patient, the indication for paracetamol and ibuprofen was recorded and whether the patient was exempt from prescription charges. The data were combined and descriptive statistical analysis undertaken. Patients recorded as exempt from prescription charges were assessed to determine whether the indication for prescribing paracetamol or ibuprofen would have made them eligible for supply under the Pharmacy First scheme. Ethical approval was not required for the study.

Results
Of the 120 patients included, 55 (46%) were prescribed ibuprofen and 65 (54%) were prescribed paracetamol. The main indications recorded for paracetamol and ibuprofen were pain (39% of patients prescribed paracetamol and 64% of patients prescribed ibuprofen) and pain associated with infection (29% of patients prescribed paracetamol and 20% of patients prescribed ibuprofen), but no indication was recorded for 23% of patients prescribed paracetamol and 7% of patients prescribed ibuprofen. Lower limb pain (11 patients), back pain (10 patients) and headache (10 patients) were the most common types of pain that ibuprofen and paracetamol were prescribed for. Respiratory infections (16 patients) and urinary tract infections (8 patients) were the most common infections associated with pain for which paracetamol or ibuprofen was prescribed. Of the 68 patients who were exempt from prescription charges, 16 (24%) could have been treated under the Pharmacy First Scheme.

Conclusion
The findings suggest that approximately a quarter of the sample of patients prescribed paracetamol or ibuprofen and exempt from prescription charges could have been treated under the Pharmacy First scheme. This may have been higher, but the prescribing indication was not recorded for all patients. This suggests that significant savings in GP time and prescribing costs could be achieved at these three practices. Further work is needed to assess the extent to which savings could be achieved at other practices.

Item Type: Article
Subjects: R Medicine > RS Pharmacy and materia medica
Divisions: Faculty of Medicine and Health Sciences > School of Pharmacy
Depositing User: Symplectic
Date Deposited: 06 Jun 2018 13:31
Last Modified: 10 Jul 2019 14:36
URI: https://eprints.keele.ac.uk/id/eprint/4984

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