Centralized network may reduce inappropriate filled prescriptions

By Sarah Guy, medwireNews Reporter

Implementing a centralized network that links province-wide pharmacy and hospital data could reduce the number of inappropriate filled prescriptions, show Canadian study results.

The researchers report a dramatic fall in the number of inappropriate filled prescriptions for opioids and benzodiazepines within 6 months of PharmaNet - a centralized prescription network containing up-to-date prescription records for all residents - being instigated in British Columbia.

"Even modest reductions in inappropriate prescriptions are clinically meaningful," say Colin Dormuth (University of British Columbia, Vancouver) and colleagues in the Canadian Medical Association Journal.

"If our findings can be generalized to other jurisdictions, we estimate that such networks could eliminate millions of inappropriate filled prescriptions in the United States and Canada annually," they add.

The team investigated the change in rates of inappropriate filled prescriptions of opioids and benzodiazepines - controlled substances that are particularly prone to misuse or resale - using data from 30 months preceding and 30 months after the implementation of PharmaNet.

Over 1.3 million prescriptions were filled by 86,704 patients for opioids during the data period, and over 1.4 million prescriptions for benzodiazepine were filled by 47,983 patients.

Dormuth and co-workers defined inappropriate filled prescriptions as those filled by patients who had already been prescribed, and had filled, a prescription for the same drug from a different physician dispensed at a different pharmacy, within 7 days of the original prescription.

In all, 3.2% of opioid and 1.2% of benzodiazepine prescriptions were deemed inappropriately filled during the 30 months before PharmaNet, note the researchers.

After its implementation, there was a 32.8% relative reduction in inappropriate prescriptions for opioids and a 48.6% reduction in inappropriate prescriptions for benzodiazepines, they observe. These translate to average absolute reductions of 1.08% and 0.49%, respectively.

The finding followed the same trend when the cohort comprised only residents aged 65 years or older, with estimated relative reductions for opioids and benzodiazepines of 0.28% and 0.05%, respectively.

"These findings provide empirical evidence that centralized prescription networks can reduce inappropriate prescribing and dispensing of prescriptions by offering healthcare professionals real-time access to prescription data," conclude Dormuth and team.

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