Show simple item record

dc.contributor.authorPetty, Duncan R.*
dc.contributor.authorSilcock, Jonathan*
dc.date.accessioned2011-01-05T14:45:48Z
dc.date.available2011-01-05T14:45:48Z
dc.date.issued2011-01-05T14:45:48Z
dc.identifier.citationPetty, D. R. and Silcock, J. (2008). Explanations for variations in clopidogrel prescribing in England. Journal of Public Health, Vol. 30, No. 4, pp. 494-498. Oxford Journals. ISSN 1741-3842.en
dc.identifier.urihttp://hdl.handle.net/10454/4666
dc.descriptionnoen
dc.description.abstractThe National Audit Office (NAO) has produced prescribing indicators that Primary Care Trusts (PCTs) can use to judge their performance. One of the indicators is for the antiplatelet clopidogrel, measured as defined daily dose (DDD) per cardiovascular Specific Therapeutic Age Related Prescribing Unit (STAR-PU). Clopidogrel is used as an indicator because it is a more expensive medicine than the alternative (aspirin) and there may be scope for cost reduction. We aimed to establish if the NAO indicator for clopidogrel prescribing is a valid measure of prescribing performance. Methods Prescribing data for 152 PCTs and a range of explanatory variables were obtained. Correlation between variables was determined. A regression analysis was conducted to compare the dependent variable (prescribing) with the explanatory variables identified. Results The percentage of patients on the coronary heart disease register and Index of Multiple Deprivation explained 30% of the variation in prescribing (DDD/STAR-PU) between PCTs. Even though DDD/STAR-PU is adjusted for age and sex other measures of need still have an impact on prescribing. Conclusions Using DDD/STAR-PU alone as a prescribing indicator might misidentify some PCTs, which are under- and over-using clopidogrel. Poor ranking against other PCTs using the NAO indicator should be fully explored taking into account other variables (cardiovascular morbidity and deprivation) before any corrective action is taken.en
dc.language.isoenen
dc.subjectPrescribingen
dc.subjectEconomicsen
dc.subjectPrimary careen
dc.subjectCardiovascular diseaseen
dc.subjectClopidogrelen
dc.titleExplanations for variations in clopidogrel prescribing in England.en
dc.status.refereedYesen
dc.typeArticleen
dc.identifier.JournalTitleJournal of Public Health 2008; 30: 494-498en
dc.identifier.doihttps://doi.org/10.1093/pubmed/fdn048


This item appears in the following Collection(s)

Show simple item record