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GP prescribing in Northern Ireland by deprivation index: retrospective analysis
  1. John Scott Frazer1 and
  2. Glenn Ross Frazer2
  1. 1Somerville College, University of Oxford, Oxford, UK
  2. 2School of Mathematics and Physics, Queen's University Belfast, Belfast, UK
  1. Correspondence to Dr John Scott Frazer; sfrazer504{at}gmail.com

Abstract

Objective In the present study, we sought to explore the relationship between socioeconomic status and prescribing magnitude and cost in primary care throughout Northern Ireland.

Design We performed a retrospective data analysis of general practitioner (GP) prescribing using open-source databases with data collected from May to October 2019 to determine the number of prescriptions and cost of drugs and drug classes by area, ranking these by deprivation index. We used Kendall’s tau to quantify the relationship between prescribing and deprivation.

Setting We analysed open-source data collected from 325 GP practices in Northern Ireland during the period from May to October 2019.

Participants We analysed a total of 2 764 303 prescriptions signed during our study period.

Results Our study indicates a clear trend of increased overall spending per patient (r=−0.1232, p=0.02) and number of prescriptions per patient (r=−0.3440, p<0.001) in areas of higher deprivation. The mean cost per item was higher in less deprived areas (r=0.3809, p<0.001). Overall, £13.79 more was spent and 3.5 more items were prescribed per patient in the most compared with the least deprived decile, although more expensive items tended to be prescribed in areas with lower socioeconomic deprivation (£11.27 per item vs £9.20 per item). We found a statistically significant correlation of prescribing of key drug classes, such as bronchodilators, antidepressants and drugs used to treat diabetes, among others, with greater deprivation. Prescribing of vaccines and drugs used in the treatment of glaucoma was correlated with lower deprivation.

Conclusion We provide an exploration of the correlation of prescribing with deprivation by analysing all prescriptions signed within a 6-month period in Northern Ireland. Our study broadly agrees with published literature, although a few notable exceptions are highlighted. We provide evidence of discrepancies in medication cost between areas of differing deprivation and suggest possible explanations for these trends. This information will be valuable for future investigation of disease prevalence, as well as targeting of patient education and future funding.

  • chronic disease
  • community medicine
  • health equity
  • social determinants of health
  • general practice
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors JSF and GRF conceived of the study design, analysed the data, drafted the manuscript and figures, and provided critical revision. JSF additionally provided details of clinical correlation of results for the discussion.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval There are no specific ethical declarations for this work, as non-identifiable, retrospective, open-source data were used.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data regarding correlation coefficients for each drug can be made available upon reasonable request from the corresponding author.

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