The following documents are available for download (pdf format):

An American Reflection on DURQUIM by Jerry Avorn

Recommendations of an European Expert Meeting on indicators of prescribing quality in drug utilization research

Presentations of participating countries

Mechelen May 2004, Belgium

Appropriate use of medicines is of critical importance for patients achieving good health and for the efficient use of resources in health care systems. The proper use of medicines is relevant for patients, for health care professionals, for policy- and decision-makers in health care systems, as well as for the pharmaceutical industry. Over the last many years numerous studies have indicated that problems continue to arise with the use of medicines: the wrong medicine, the wrong duration of treatment, inadequate dosing schemes, and under-treatment among others. In order to analyze these patterns and to implement strategies for improving the prescribing and use of medicines, indicators are needed.

To date, various indicators have been used to identify problems in the quality of prescribing, to monitor changes and to provide feedback to individual prescribers. However, there is still considerable debate about the usefulness, reliability and validity of the different indicators. EuroDURG, supported by the WHO/EURO and the RIZIV, assembled in May 2004 a group of experts to discuss the topic of prescribing quality indicators in Mechelen, Belgium. Forty experts from 19 countries, all practically involved in the development and application of prescribing quality indicators, discussed for 2 ½ days prescribing quality indicators. The prime objective of the meeting was to develop a conceptual framework to construct indicators of prescribing quality. Recommendations were formulated for the development and application of prescribing quality indicators for associations of health care providers and European and national health authorities. The meeting primarily focused on ambulatory primary care.

Output of the meeting

• The recommendations of the meeting are available on this website.
• A background document is available upon request or through WHO-EURO
• At the recent ISPE-conference in Bordeaux, France in a plenary session a summary of the Mechelen meeting and the main issues regarding Prescribing Quality Indicators were presented by Flora Haaijer-Ruskamp. One parallel symposium was completely dedicated to the subject and was very well attended. Morten Andersen (DK), Steve Chapman (UK), Colleen Metge (CAN), and Lynn Weeks (AUS) gave an overview of the various aspects related to quality indicators based on the work of DURQUIM, putting the Mechelen meeting into a worldwide perspective.

The future

Currently the EuroDURG-DURQUIM scientific committee is working on publishing a series of articles in a peer reviewed journal on the key-issues addressed during the meeting: i.e. -taxonomy, data-sources, validity and use of quality indicators. Further, EuroDURG is exploring ways to specifically address Quality Indicator issues related to specific disease areas.

Peter Mol
On behalf of the DURQUIM scientific committee
p.mol@med.rug.nl