Economic analysis

Seven resource implications of independent prescribers compared to non-prescribers were originally considered: rates of prescribing tests ordered; referrals to other health professionals; frequency of follow up; consultation duration; time spent discussing the patient with other colleagues; unplanned consultations for the same condition within two months of the index consultation. Data were gathered through the observation diary, except for tests (from the retrospective audit) and unplanned consultations (from the patient follow up questionnaire). Group level comparisons of independent prescribers compared to non-prescribers for physiotherapists and podiatrists were undertaken separately for each of the seven variables.

The cost implications (British pounds 2015) of differences in consultation length and colleague’s time spent in discussion were examined by applying nationally valid unit costs [73]. A comprehensive micro level costing analysis could not be conducted because data on tests and unplanned consultations were only gathered for a sample of patients and insufficient details were available on medications, referrals and planned follow up to enable costs to be reliably ascribed. Costs that could be estimated were considered in relation to outcomes (satisfaction with consultation, satisfaction with advice, changes in health-related quality of life (EQ-5D-5L) between baseline and follow up) in a simple cost consequences framework.