Biomedical subjects

Geoffrey P Sayer

Publications and source records attributed to Geoffrey P Sayer.

4 recordsLinked to original sources

PubMed2006

Dosing frequencies in general practice--Whose decision and why?

BACKGROUND: Little is known about patient preference for dosing frequency (daily, weekly or monthly). Patient preferences and attitudes among women over 60 years of age were studied. Condition, medication experience and perceived control were assessed against preference. METHODS: One hundred and seven Australian general practitioners each recruited approximately 10 patients within three categories: those with preventable conditions (prevention of osteoporotic fracture), other chronic conditions, and acute or no conditions. RESULTS: While most patients (67%) preferred starting medications daily, differences were observed between weekly and monthly preference. Chronic/acute groups and those experienced in daily/intermittent medication preferred starting and continuing monthly. Experience of weekly preventive medication resulted in a preference for weekly dosing. Those women with more perceived control of decision making had a preference for monthly dosing. DISCUSSION: Patients prefer dosing schedules they have experienced. Condition type and perceived control in decision making also affect preferences. This study provides the first evidence about how patients determine preferences in dosing frequencies. It can assist GPs in their medication choice and patient education.

Aged↗

PubMed2003

Lessons from early large-scale adoption of celecoxib and rofecoxib by Australian general practitioners.

OBJECTIVE: To assess trends in the first two years of prescribing of COX-2-selective non-steroidal anti-inflammatory drugs (C2SNs) by Australian general practitioners. DESIGN: Retrospective analysis of deidentified electronic patient records from GPs enrolled in the General Practice Research Network (GPRN). SETTING AND PARTICIPANTS: Overall prescription rates for C2SNs and NSAIDs were assessed for all GPRN participants (437 GPs) between 1 September 1999 and 30 September 2002. Also, three cohorts of patients, with at least 12 months of prescription data, who received their first prescription for celecoxib between August and October 2000 (Cohort 1, 2366 patients), celecoxib between February and April 2001 (Cohort 2, 640 patients), and rofecoxib between February and April 2001 (Cohort 3, 608 patients) were selected for further analysis. MAIN OUTCOME MEASURES: Age and sex of patients; reason for prescription; previously prescribed pain medications and concomitant use of medications that could predispose to an adverse renal or bleeding event. RESULTS: Prescriptions for C2SNs increased dramatically after they were listed on the Pharmaceutical Benefits Scheme (PBS). C2SN prescriptions for patients aged less than 65 years accounted for 52.6%, 59.5% and 50.7% of those in Cohorts 1, 2 and 3, respectively; large numbers of patients in the study cohort had reasons recorded for prescription that did not comply with PBS restrictions, and between 36.7% and 61.3% of patients in the three cohorts had not received a prescription for any pain medication in the year before being prescribed a C2SN. Between 4.7% and 7.9% were coprescribed drugs that could cause renal complications. CONCLUSIONS: Rapid, early adoption of C2SNs by Australian GPs has resulted in prescribing and drug use patterns that were not in accord with quality use of medicine (QUM) principles.

Adolescent↗

PubMed2003

The General Practice Research Network: the capabilities of an electronic patient management system for longitudinal patient data.

PURPOSE: To evaluate the potential of a general practice research database derived directly from de-identified electronic medical records to provide national prescribing data in Australia. To observe the utilisation of a computer-based patient management system over time. To evaluate the impact of the research network participation on data quality in participants' electronic records. METHOD: A random sample of 297 general practitioners (GPs) from 128 practices provided longitudinal patient data from electronic medical records (using Medical Director software) retrospectively from 1 January 1999 to April 2002. The General Practice Research Network (GPRN) database contains approximately 600,000 patients, representing over 4 million prescriptions from 4 million encounters. The quality and representativeness of data for prescribing, morbidity and software usage were evaluated by comparison with National data. RESULTS: Older GPs (> 55) were under-represented, perhaps due to lower computer usage rates, but patient visits were similar to the national distribution. Over time, there were increases in: the quality of prescribing data (with reason for visit/prescription being compulsorily recorded); recording of non-prescribing visits; and the use of other features of the electronic patient management software. CONCLUSIONS: Data derived from electronic general practice records is of sufficient quality to be used to provide national prescribing estimates and has potential value for pharmacoepidemiology and population health monitoring. Such longitudinal data has previously been unavailable in Australia. Monitoring of software usage demonstrates the evolution of the Australian GP user and will be increasingly useful in assessing and improving the quality of electronic medical records.

Australia↗

PubMedDate not supplied

Acute bronchitis in Australian general practice. A prescription too far?

OBJECTIVE: To quantify how frequently general practitioners in Australia prescribe antibiotics for acute bronchitis, which antibiotics are used, and whether there are subgroups of patients who might benefit from their use. DESIGN AND SETTING: A retrospective descriptive study using 3 sets of data: Australian Sentinel Practice Research Network, the Bettering the Evaluation and Care of Health (BEACH) Program, and the General Practice Research Network (GPRN). RESULTS: Over 50% of all patients with 'acute bronchitis' had either chest or one or more systemic signs on physical examination. The rate of antibiotic prescribing for acute bronchitis was 79.6% of acute bronchitis visits using BEACH data 2001-2002 and varied from 68.6 (95% CI: 62.8-74.5%) in 2001 to 78.7 (95% CI: 72.2-85.2%) in 1999 using GPRN data. Penicillins, followed by macrolides, were the most commonly prescribed antibiotics. DISCUSSION: Australian GPs frequently prescribe antibiotics for 'acute bronchitis' despite guidelines to the contrary. One reason may be that many patients present with chest or systemic signs.

Acute Disease↗