Variation in prescription duration for long term conditions: a cohort study in English NHS primary care using OpenPrescribing

Abstract Background Many patients receive routine medications for long-term conditions (LTCs). Doctors typically issue repeat prescriptions in one to three month durations, but England currently has no national guidance on the optimal duration. Methods We calculated the duration of prescriptions for common LTCs in England over a 12-month period (December 2018-November 2019). We assessed the level of variation between regional clinical commissioning groups (CCGs) and determine practice factors associated with different durations. Results Of the common medications included, 28-day (one-monthly) prescriptions accounted for 48.5% (2.5 billion) tablets/capsules issued. There was very wide regional variation in the proportion of 28-day prescriptions (7.2% to 95.0%). Practice dispensing status was the most likely predictor of prescription duration. The proportion of patients with LTCs and the electronic health record software used by a practice were also associated with prescription duration. Conclusions One month prescription durations are common for patients taking medicines routinely for long term conditions, particularly in dispensing practices. Electronic health record configurations offer an opportunity to implement and evaluate new policies on repeat prescription duration in England.