Auditing GPs' prescribing habits: Cardiovascular prescribing frequently continues medication initiated by specialists

Objective: To determine to what extent general practitioners' (GPs) prescribing behaviour is a result of repeat prescribing of medication which has been initiated by specialists. Method: During a 4-week period, pharmacists identified GPs' prescriptions for a large group of cardiovascular drugs. Next, questionnaires were sent to the prescribing GPs to find out whether the prescriptions were in fact repeat prescriptions. If they were, the GPs were asked whether or not they had originally been prescribed by a specialist. Setting: Six pharmacies in the northeastern part of the Netherlands. Subjects: Fourty-four GPs, 39 of whom responded. Results: Of 1648 questionnaires, 1342 (81%) were returned. Of drugs for cardiovascular therapy that the GPs prescribed, 66% had originally been prescribed by specialists. Conclusions: For many cardiovascular drugs, GPs' prescriptions predominantly originated from specialists' prescribing. For more reliable attribution of prescription data or prescribing behaviour to either specialists or to GPs, similar studies should be made for other drug groups. Since the extent of repeat prescribing is high, qualitative studies should be made of the appropriateness of chronic medication, initiated by specialists and continued in repeat prescribing by GPs.