Document Detail


Effect of a centralized prescription network on inappropriate prescriptions for opioid analgesics and benzodiazepines.
MedLine Citation:
PMID:  22949563     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Opioid analgesics and benzodiazepines are often misused in clinical practice. We determined whether implementation of a centralized prescription network offering real-time access to patient-level data on filled prescriptions (PharmaNet) reduced the number of potentially inappropriate prescriptions for opioids and benzodiazepines.
METHODS: We conducted a time series analysis using prescription records between Jan. 1, 1993, and Dec. 31, 1997, for residents of the province of British Columbia who were receiving social assistance or were 65 years or older. We calculated monthly percentages of filled prescriptions for an opioid or a benzodiazepine that were deemed inappropriate (those issued by a different physician and dispensed at a different pharmacy within 7 days after a filled prescription of at least 30 tablets of the same drug).
RESULTS: Within 6 months after implementation of PharmaNet in July 1995, we observed a relative reduction in inappropriate filled prescriptions for opioids of 32.8% (95% confidence interval [CI] 31.0%-34.7%) among patients receiving social assistance; inappropriate filled prescriptions for benzodiazepines decreased by 48.6% (95% CI 43.2%-53.1%). Similar and statistically significant reductions were observed among residents 65 years or older.
INTERPRETATION: The implementation of a centralized prescription network was associated with a dramatic reduction in inappropriate filled prescriptions for opioids and benzodiazepines.
Authors:
Colin R Dormuth; Tarita A Miller; Anjie Huang; Muhammad M Mamdani; David N Juurlink;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-09-04
Journal Detail:
Title:  CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne     Volume:  184     ISSN:  1488-2329     ISO Abbreviation:  CMAJ     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-06     Completed Date:  2013-01-16     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  9711805     Medline TA:  CMAJ     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  E852-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, University of British Columbia, Vancouver, BC, Canada. colin.dormuth@ti.ubc.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analgesics, Opioid / therapeutic use*
Benzodiazepines / therapeutic use*
British Columbia
Confidence Intervals
Cross-Sectional Studies
Databases, Factual
Drug Prescriptions / standards*,  statistics & numerical data
Drug Therapy, Computer-Assisted*
Drug Utilization / statistics & numerical data,  trends
Drug and Narcotic Control / organization & administration
Electronic Prescribing
Female
Humans
Inappropriate Prescribing / prevention & control*,  statistics & numerical data
Incidence
Information Services / organization & administration*
Male
Middle Aged
Organizational Innovation
Pharmaceutical Services / organization & administration*
Quality Control
Retrospective Studies
Grant Support
ID/Acronym/Agency:
ETG-92247//Canadian Institutes of Health Research
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 12794-10-4/Benzodiazepines
Investigator
Investigator/Affiliation:
David N Juurlink / ; Colin R Dormuth / ; Chelsea Hellings / ; Anita L Kozyrskyj / ; Muhammad M Mamdani / ; Yola Moride / ; J Michael Paterson / ; Colette Raymond / ; Robyn Tamblyn /
Comments/Corrections
Comment In:
CMAJ. 2012 Nov 6;184(16):1767-8   [PMID:  23008488 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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