{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T01:44:54Z","timestamp":1791769494266,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To quantify between\u2010practice variation in potentially inappropriate prescribing (PIP) among middle\u2010aged adults (45\u201364\u2009years) in UK general practice, and to identify patient\u2010 and practice\u2010level characteristics associated with PIP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Repeated cross\u2010sectional study using linked data from the Lambeth DataNet and Quality Outcomes Framework across 41 GP practices in South London (2014\u20132019). The study included patients aged 45\u201364\u2009years prescribed \u22651 medicines in each year from 2014 to 2019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200946\u2009633\u201352\u2009582). PIP was identified using the 22 PROMPT (PRescribing Optimally in Middle\u2010aged People's Treatments) criteria. Multilevel negative binomial regression estimated associations with patient\u2010 and practice\u2010level characteristics, expressed as rate ratios (RR) with 95% confidence intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PIP prevalence was 18%\u201320%, stable across the study period. Practice\u2010level prevalence ranged from 14% to 24%. The SCV was 1.72 (low) and the ICC was 0.08, with approximately 8% of variance attributable to practice\u2010level differences. Polypharmacy was the strongest predictor (adjusted RR 4.04, 95% CI 3.96\u20134.11), followed by multimorbidity (RR 2.44, 95% CI 2.40\u20132.50). Black\/African\/Caribbean\/Black British ethnicity was associated with lower PIP (RR 0.77, 95% CI 0.75\u20130.78). Practice\u2010based pharmacist presence and teaching practice status were associated with modestly lower PIP, while APMS contract type was associated with higher PIP (RR 1.20, 95% CI 1.10\u20131.32).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most variation occurred at the patient level, but practice organizational characteristics were also associated with PIP and warrant further investigation in an age group for which direct medicines\u2010optimization evidence remains limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70866","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:59:11Z","timestamp":1791766751000},"source":"Crossref","is-referenced-by-count":0,"title":["Practice\u2010level variation in potentially inappropriate prescribing in middle\u2010aged adults: A repeated cross\u2010sectional study in South London general practice"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7518-4970","authenticated-orcid":false,"given":"Ryan","family":"Jayesinghe","sequence":"first","affiliation":[{"name":"Department of Professional and Continuing Education University of Cambridge  Cambridge UK"},{"name":"Department of General Practice RCSI University of Medicine and Health Sciences  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7663-2405","authenticated-orcid":false,"given":"Amandeep","family":"Khatter","sequence":"additional","affiliation":[{"name":"School of Population Health and Environmental Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4098-5399","authenticated-orcid":false,"given":"Stevo","family":"Durbaba","sequence":"additional","affiliation":[{"name":"School of Population Health and Environmental Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6514-9904","authenticated-orcid":false,"given":"Mark","family":"Ashworth","sequence":"additional","affiliation":[{"name":"School of Life Course and Population Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1119-064X","authenticated-orcid":false,"given":"Benjamin","family":"Jacob","sequence":"additional","affiliation":[{"name":"Department of General Practice RCSI University of Medicine and Health Sciences  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9838-3625","authenticated-orcid":false,"given":"Frank","family":"Moriarty","sequence":"additional","affiliation":[{"name":"School of Pharmacy and Biomolecular Sciences RCSI University of Medicine and Health Sciences  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3929-2018","authenticated-orcid":false,"given":"Patrick","family":"Redmond","sequence":"additional","affiliation":[{"name":"Department of General Practice RCSI University of Medicine and Health Sciences  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afm189"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2373"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0043617"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010014\u20100484\u20106"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228\u2010015\u20102003\u2010z"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2020.1048"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102017\u2010016562"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40267\u2010021\u201000884\u20105"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3399\/BJGPO.2023.0209"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102015\u2010008270"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102296\u201015\u201059"},{"key":"e_1_2_11_13_1","volume-title":"Variations in health care","author":"Appleby J","year":"2011"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm7100320"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2004.029454"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1027\/1614\u20102241.1.3.86"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20112025\u2011115606"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(12)60240\u20102"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanhl.2025.100774"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875\u2010022\u201001952\u2010z"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.17965"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp09X454179"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010024\u201003332\u2010z"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003672"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2020.0948"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.16030"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed\u20102022\u2010000392"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875\u2010016\u20100507\u2010y"}],"container-title":["British Journal of Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bcp.70866","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bcp.70866","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bcp.70866","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:59:13Z","timestamp":1791766753000},"score":1,"resource":{"primary":{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/10.1002\/bcp.70866"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,11]]},"references-count":27,"alternative-id":["10.1002\/bcp.70866"],"URL":"https:\/\/doi.org\/10.1002\/bcp.70866","archive":["Portico"],"relation":{},"ISSN":["0306-5251","1365-2125"],"issn-type":[{"value":"0306-5251","type":"print"},{"value":"1365-2125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,11]]},"article-number":"bcp.70866"}}