Table 2.
Practice* | Randomised group† | Approximate list size and full time equivalent (FTE) GPs | Sampling (initial change in prescribing and size) | Overall high-risk prescribing rate at baseline‡ | The process for delivering the intervention to patients, both planned by the practice and actual (based on interview and observational data) |
---|---|---|---|---|---|
Orosay | 2 | 10 000 6.5 FTE |
Not reducing Large |
6.6 | Failure to legitimise and no process to implement agreed, but the most engaged GP said there was some change in clinical practice |
Boreray | 10 | 6500 3.5 FTE |
Not reducing Large |
2.5 | Initially agreed to divide the work between GPs, but failed to implement because of understaffing/prioritisation of clinical work |
Hellisay | 9 | 3000 1.9 FTE |
Not reducing Small |
7.0 | Initially agreed that one GP would review, but actually divided the work. Staff changes meant they could not maintain reviewing |
Mingulay | 3 | 9000 5 FTE |
Not reducing Large |
3.2 | Initially agreed that one GP would review all patients in set 2 hours/month. This was inadequate, and poor GP to GP communication further reduced impact |
Gighay | 7 | 2500 1.9 FTE |
Not reducing Small |
3.4 | Initially agreed that one GP would review all patients and flag notes for when next seen, so relied on patient consulting and other GPs acting on the flag |
Lingay | 4 | 3000 2 FTE |
Not reducing Small |
5.0 | Initially agreed to divide the work, but did not implement; one GP systematically and enthusiastically reviewed after a delay |
Scalpay | 6 | 3000 2 FTE |
Reducing Small |
3.7 | Did not agree process at EOV, but rapid implementation of one GP systematically reviewing all patients |
Hirta | 8 | 5500 4.3 FTE |
Reducing Large |
4.2 | Initially agreed to divide the work and rapidly delivered by all GPs initially reviewing. Once initial bulk of reviews done, one GP maintained reviewing |
Monach | 1 | 3500 2.7 FTE |
Reducing Small |
7.1 | Initially agreed to divide the work, but actually rapid implementation by one GP doing all the reviewing |
Taransay | 5 | 6000 4 FTE |
Reducing Large |
3.7 | Initially agreed to divide the work, with rapid implementation by all GPs carrying out the reviewing |
*Ordered from top to bottom in terms of the practices judged from qualitative analysis to have been the least (top) to most (bottom) successful implementers.
†Practice group in terms of when started the intervention (1= first group to start, 10= last group to start).
‡Mean practice rate of high-risk prescribing in the 2 years before starting the intervention.