Older people, prescribed drug consumption and the general practitioner contract

Abstract

This paper draws on data obtained in the first year of a longitudinal study designed to monitor the effect of the general practitioner contract and the 1990 NHS and Community Care Act. The study focuses on the care received by people over the age of 75 living in areas covered by four first wave community trusts. One objective of the first year of this study was to examine the impact of the general practitioner (GP) contract particularly with regard to drug consumption and nursing input. Random samples of older people were obtained from family health services authorities in the four trust areas. Health visitors were recruited in each locality and were trained to conduct the interviews. A total of 775 people were interviewed and assessed for functional, physical, mental, emotional and social status. Each person was asked whether they had been given a health check, who had been involved and where this was carried out. They were also asked to show those medicines they had taken in the 24 h before they were interviewed. Multivariate analysis showed that after controlling for physical symptoms, functional ability, pathology, admission to hospital in the previous 12 months, socio-economic class, self-health ratings and consultations with their doctor, those who had been given a health check had consumed fewer drugs. The implications of these findings for the drugs budget are calculated. The results of the study suggest that savings on the drugs budget may offset to a large extent the additional costs of employing practice nurses to undertake health checks but further research is indicated.