REVISIT, the next stage: developing plans for wider application of a retrospective review of prescribing of GPs in training

Background The GMC PRACtICe study identified prescribing errors in general practice occurring at a rate of 5%. GPs in training (GP AiTs) were highlighted as a group who may benefit from further help to reduce their prescribing errors. A recent pilot study explored the effect of reviewing 100 sequential prescriptions issued by ten GPs AiTs. The error rate in this small cohort (the REVISIT study) was found to be nearly double that reported in the PRACtICe study (9%). Three-month follow-up interviews with GP AiTs and their trainers provided useful insight into prescribing behaviour and rationale for behaviour change. Aim Should the revisit intervention be rolled out or is further development required? Method Interviews with 30 stakeholders or stakeholder organisations were performed during which results from the REVISIT study were presented, and plans for development explored. Stakeholders included organisations involved with training and regulating GPs and pharmacists, as well as other interested parties such as GP AiTs and members of the public. Interviews were recorded, transcribed and analysed for emergent themes. Results There was broad support for further development of the REVISIT programme, with several stakeholders expressing surprise that this intervention is not already everyday practice. Caution was expressed about the way in which such an intervention could be viewed by participants: a supportive, developmental approach was preferred. Stakeholders also discussed the stage of training that such an intervention should occur within, and postulated other groups of prescribers who may benefit from similar interventions. Conclusion Findings from the REVISIT study confirmed that GP AiTs benefited from personalised prescribing review. By conducing systematic stakeholder interviews we aim to elucidate whether a larger intervention study is required, or whether the REVISIT process can be implemented universally or in a targeted format.