{
  "abstract": "Background Dispensing General Practices—those with in-house pharmacies that receive payment for each dispensed prescription—incur higher prescription costs than non-dispensing practices and tend to be in more affluent areas. One proposed explanation, observed internationally, is that dispensing practices issue shorter prescriptions to increase the number of prescriptions dispensed, thereby generating more fees. This study examines whether dispensing status influences prescription length in England.Methods We conducted a quasi-experimental, repeated-measures, cross-sectional study of English general practices. Business administration data classified practices by dispensing status and were used to calculate the percentage of patients eligible for dispensing and the average prescription length (in days) for seven drugs with fixed dosing regimens. Data were recorded at three-month intervals from July 2023 to April 2024. We used generalised estimating equations (GEE) to assess the relationship between (1) dispensing status and (2) the proportion of patients eligible for dispensing with prescription length. Models adjusted for patient characteristics (age, sex) and practice factors (deprivation score, list size).Results Dispensing practices prescribed shorter average durations than non-dispensing practices. The largest difference was observed for Desogestrel, which was prescribed for 21.9 fewer days (95%CI 24.5–19.4), followed by 9.9 days for Indapamide Standard Release (95%CI 10.5–9.2), 9.7 days for Indapamide Modified Release (95%CI 10.3–9.1), 8.4 days for Ezetimibe (95%CI 9.0–7.8), 7.2 days for Tamsulosin (95%CI 7.9–6.5), 6.6 days for Alendronic Acid (95%CI 7.1–6.2), and 5.9 days for Dapagliflozin (95%CI 6.4–5.3).A higher proportion of patients eligible for dispensing was associated with significantly shorter prescription lengths. For every 10% increase in eligible patients, prescription length decreased by 1.7 days for Desogestrel (95%CI 2.3–1.1), 0.4 days for Indapamide Standard Release (95%CI 0.6–0.3), 0.4 days for Ezetimibe (95%CI 0.5–0.3), 0.4 days for Tamsulosin (95%CI 0.5–0.3), 0.3 days for Indapamide Modified Release (95%CI 0.5–0.2), 0.3 days for Dapagliflozin (95%CI 0.4–0.2), and 0.3 days for Alendronic Acid (95%CI 0.4–0.2).Dispensing practices more consistently prescribed medications for 28–31 days, whereas non-dispensing practices showed greater variation.Conclusion Dispensing practices prescribe consistently shorter courses of medication, whereas non-dispensing practices have greater variation in prescription lengths. This analysis alone does not clarify the extent of financial benefit for dispensing practices nor the impact on patient care. A lack of clear guidance on prescription lengths likely contributes to these variations. To improve consistency, central bodies should consider providing clearer recommendations for optimal prescription durations.",
  "authors": [
    {
      "affiliations": [
        "Wolfson Institute of Population Health, Queen Mary University of London, London, UK"
      ],
      "name": "Ian Holdroyd"
    },
    {
      "affiliations": [
        "Wolfson Institute of Population Health, Queen Mary University of London, London, UK"
      ],
      "name": "Cameron Appel"
    },
    {
      "affiliations": [
        "Wolfson Institute of Population Health, Queen Mary University of London, London, UK"
      ],
      "name": "Liam Loftus"
    },
    {
      "affiliations": [
        "Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"
      ],
      "name": "Efthalia Massou"
    },
    {
      "affiliations": [
        "Wolfson Institute of Population Health, Queen Mary University of London, London, UK"
      ],
      "name": "John Ford"
    }
  ],
  "title": "OP38 Dispensing practices prescribe shorter prescription lengths compared to non-dispensing practices",
  "uid": "f2ca142f-9925-5ed4-85fe-a0bd32142938"
}