GPs prescribing less, counselling more

General practitioners are prescribing fewer medications overall for their patients than they were four years ago-particularly antibiotics, some analgesics, and respiratory drugs-according to a new report released today by the University of Sydney and the Australian Institute of Health and Welfare.

But there were also significant increases in rates of treatment with non-steroidal anti-inflammatory drugs (NSAIDs), typically used to treat arthritic pain, and cholesterol-lowering drugs such as statins for patients with cardiovascular disease.

General Practice Activity in Australia 2001-02 is based on an ongoing survey of 100,000 doctor-patient consultations from a random sample of 1000 GPs a year. It gives an insight into why people visit their GP, health problems managed, and types of treatments received.

The report shows that antibiotics, and cardiovascular and central nervous system-related drugs were those most frequently prescribed by doctors.

Antibiotics accounted for 4 of the top 10 medications most frequently prescribed by GPs, but the prescription rate for these drugs fell from 17.3 to 14.5 per 100 consultations between 1998-99 and 2001-02.

Director of the AIHW's General Practice Statistics and Classification Unit at the University of Sydney, Professor Helena Britt, said that doctors now seemed to be prescribing less and counselling more.

'For every 100 consultations in 1998-99, for example, the average GP prescribed 94 medications, advised or counselled the patients 31 times and undertook 12 procedures.'

'Four years later, GPs are prescribing less medication-88 per 100 consultations-and they are giving advice or counselling 38 times, and undertaking 14 procedures.

'Such a change has a huge impact when we realise there are over 100 million GP-patient consultations in Australia every year.'

Dr Britt said that the increase in prescription of NSAIDs (up from 4.5 to 5.3 per 100 consultations) was almost entirely explained by an increase in prescriptions for a relatively new group of drugs known as coxibs, usually prescribed for the treatment of arthritic pain.

'In many cases coxibs are probably being prescribed for patients who were not previously able to take NSAIDs, perhaps because of the possible side effects of those available in the past.'

The increase in prescription of lipid-lowering agents for control of blood cholesterol levels parallels a significant rise in the rate of management of lipid disorders over the last 3 years.

'GPs are now managing lipid problems on an extra 180,000 occasions every year,' Professor Britt said.

'This overall increase appears to be a combination of a steady number of new cases and a growing pool of patients continuing on long-term therapy.'

Overall, the problems most frequently managed by doctors were hypertension (9 per 100 consultations), upper respiratory tract infection (6.2 per 100), vaccination (4.7 per 100), and depression (3.4 per 100).


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