Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis
Objectives To explore available data sources, secondary uses and key considerations for optimising the actionability of primary care prescribing data to improve quality of care in the Dutch context.Design An exploratory qualitative study was undertaken based on semi-structured interviews. We anchore...
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| Format: | Article |
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e062349.full |
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| author | Robert A Verheij Niek Klazinga Erica Barbazza Lotte Ramerman Dionne Kringos |
| author_facet | Robert A Verheij Niek Klazinga Erica Barbazza Lotte Ramerman Dionne Kringos |
| author_sort | Robert A Verheij |
| collection | DOAJ |
| description | Objectives To explore available data sources, secondary uses and key considerations for optimising the actionability of primary care prescribing data to improve quality of care in the Dutch context.Design An exploratory qualitative study was undertaken based on semi-structured interviews. We anchored our investigation around three tracer prescription types: antibiotics; benzodiazepines and opioids. Descriptive and explanatory themes were derived from interview data using thematic analysis.Setting Stakeholders were sampled from across the micro (clinical), meso (organisational) and macro (policy) contexts of the Dutch primary care system.Participants The study involved 28 informants representing general practitioners (GPs), community pharmacists, regional chronic care networks (care groups), academia and research institutes, insurers, professional associations, electronic health record (EHR) vendors and national authorities.Results In the Netherlands, three main sources of data for improving prescribing in primary care are in use: clinical data in the EHRs of GP practices; pharmacy data in community pharmacy databases and claims data of insurers. While the secondary use of pharmacy and claims data is well-established across levels, the use of these data together with EHR data is limited. Important differences in the types of prescribing information needed by micro-meso-macro context are found, though the extent to which current indicators address these varies by prescription type. Five main themes were identified as areas for optimising data use: (1) measuring what matters, (2) increasing data linkages, (3) improving data quality, (4) facilitating data sharing and (5) optimising fit for use analysis.Conclusions To make primary care prescribing data useful for improving quality, consolidated patient-specific data on the indication for a prescription and dispensed medicine, over time, is needed. In the Netherlands, the selection of indicators requires further prioritisation to better signal the appropriateness and long-term use of prescription drugs. Prioritising data linkages is critical towards more actionable use. |
| format | Article |
| id | doaj-art-54c5cd1425f8461d826666c1dfa685f9 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-54c5cd1425f8461d826666c1dfa685f92025-01-31T19:10:11ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2022-062349Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysisRobert A Verheij0Niek Klazinga1Erica Barbazza2Lotte Ramerman3Dionne Kringos4Learning Health Systems Research Programme, Netherlands Institute for Health Services Research, Utrecht, The NetherlandsDepartment of Public and Occupational Health, Amsterdam UMC Locatie AMC, Amsterdam, The NetherlandsDepartment of Public and Occupational Health, Amsterdam UMC Locatie AMC, Amsterdam, The NetherlandsLearning Health Systems Research Programme, Netherlands Institute for Health Services Research, Utrecht, The NetherlandsDepartment of Public and Occupational Health, Amsterdam UMC Locatie AMC, Amsterdam, The NetherlandsObjectives To explore available data sources, secondary uses and key considerations for optimising the actionability of primary care prescribing data to improve quality of care in the Dutch context.Design An exploratory qualitative study was undertaken based on semi-structured interviews. We anchored our investigation around three tracer prescription types: antibiotics; benzodiazepines and opioids. Descriptive and explanatory themes were derived from interview data using thematic analysis.Setting Stakeholders were sampled from across the micro (clinical), meso (organisational) and macro (policy) contexts of the Dutch primary care system.Participants The study involved 28 informants representing general practitioners (GPs), community pharmacists, regional chronic care networks (care groups), academia and research institutes, insurers, professional associations, electronic health record (EHR) vendors and national authorities.Results In the Netherlands, three main sources of data for improving prescribing in primary care are in use: clinical data in the EHRs of GP practices; pharmacy data in community pharmacy databases and claims data of insurers. While the secondary use of pharmacy and claims data is well-established across levels, the use of these data together with EHR data is limited. Important differences in the types of prescribing information needed by micro-meso-macro context are found, though the extent to which current indicators address these varies by prescription type. Five main themes were identified as areas for optimising data use: (1) measuring what matters, (2) increasing data linkages, (3) improving data quality, (4) facilitating data sharing and (5) optimising fit for use analysis.Conclusions To make primary care prescribing data useful for improving quality, consolidated patient-specific data on the indication for a prescription and dispensed medicine, over time, is needed. In the Netherlands, the selection of indicators requires further prioritisation to better signal the appropriateness and long-term use of prescription drugs. Prioritising data linkages is critical towards more actionable use.https://bmjopen.bmj.com/content/12/7/e062349.full |
| spellingShingle | Robert A Verheij Niek Klazinga Erica Barbazza Lotte Ramerman Dionne Kringos Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis BMJ Open |
| title | Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis |
| title_full | Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis |
| title_fullStr | Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis |
| title_full_unstemmed | Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis |
| title_short | Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis |
| title_sort | optimising the secondary use of primary care prescribing data to improve quality of care a qualitative analysis |
| url | https://bmjopen.bmj.com/content/12/7/e062349.full |
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