RT Journal Article
SR Electronic
T1 Effect of a centralized prescription network on inappropriate prescriptions for opioid analgesics and benzodiazepines
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E852
OP E856
DO 10.1503/cmaj.120465
VO 184
IS 16
A1 Colin R. Dormuth
A1 Tarita A. Miller
A1 Anjie Huang
A1 Muhammad M. Mamdani
A1 David N. Juurlink
YR 2012
UL http://www.cmaj.ca/content/184/16/E852.abstract
AB 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.See related commentary by Wilsey and Prasad at www.cmaj.ca/lookup/doi/10.1503/cmaj.121495