BACKGROUND: The high consumption of hypolipidaemic agents warrants the study of the costs caused by these medicines being inadequately prescribed. OBJECTIVE: To quantify the economic cost generated in 1 year in primary care by inadequate (or unnecessary) prescriptions for hypolipidaemic drugs. METHODS: A cross-sectional study based on hypolipidaemic drug prescriptions for a population of pensioners ordered during 1 year by 49 family physicians from 4 health areas in Madrid, Spain. Each doctor completed a data collection sheet for each patient for whom a hypolipidaemic agent was prescribed. The adequacy of each prescription was evaluated according to 2 quality levels: for level 1, it was necessary to have knowledge of the following parameters: total cholesterol level at the start of treatment, low density lipoprotein cholesterol (LDL-C) level, whether dietary intervention preceded pharmacological treatment, patient age and risk factors; for level 2, it was not necessary to have knowledge of either diet before pharmacological treatment or LDL-C levels. Inadequate expenditure was quantified by physician, by type of doctor who initiated the pharmacological treatment (the family physician, specialist, other doctor), therapeutic group and agent. STUDY PERSPECTIVE: Primary healthcare management of 4 public health areas. RESULTS: The cost of inadequate prescriptions for hypolipidaemic drugs reached 116,480.60 US dollars ($US; 1997 values) for quality level 1 and $US37,893.37 for level 2. 12.3% of the health professionals ordered all their prescriptions inadequately (level 1). Of the total inadequate prescription expenditure, 20.4% represented treatments initiated by family physicians and 35.3% by specialists (level 1). Statins made up 78.2% of the total cost; the inadequate expenditure for this therapeutic group reached $US88,797 (level 1). Of the prescriptions for fibrates, 88% were inadequate (level 1). CONCLUSIONS: In this study, 67% of prescriptions for hypolipidaemic medicines were ordered inadequately in the pensioner population, which represents a considerable pharmacological expenditure. This percentage and the mean cost per inadequate prescription was higher if a specialist was the professional initiating the treatment. Therefore, it is necessary to run pharmaceutical prescription quality programmes with both primary care physicians and specialists involved.
BACKGROUND: The high consumption of hypolipidaemic agents warrants the study of the costs caused by these medicines being inadequately prescribed. OBJECTIVE: To quantify the economic cost generated in 1 year in primary care by inadequate (or unnecessary) prescriptions for hypolipidaemic drugs. METHODS: A cross-sectional study based on hypolipidaemic drug prescriptions for a population of pensioners ordered during 1 year by 49 family physicians from 4 health areas in Madrid, Spain. Each doctor completed a data collection sheet for each patient for whom a hypolipidaemic agent was prescribed. The adequacy of each prescription was evaluated according to 2 quality levels: for level 1, it was necessary to have knowledge of the following parameters: total cholesterol level at the start of treatment, low density lipoprotein cholesterol (LDL-C) level, whether dietary intervention preceded pharmacological treatment, patient age and risk factors; for level 2, it was not necessary to have knowledge of either diet before pharmacological treatment or LDL-C levels. Inadequate expenditure was quantified by physician, by type of doctor who initiated the pharmacological treatment (the family physician, specialist, other doctor), therapeutic group and agent. STUDY PERSPECTIVE: Primary healthcare management of 4 public health areas. RESULTS: The cost of inadequate prescriptions for hypolipidaemic drugs reached 116,480.60 US dollars ($US; 1997 values) for quality level 1 and $US37,893.37 for level 2. 12.3% of the health professionals ordered all their prescriptions inadequately (level 1). Of the total inadequate prescription expenditure, 20.4% represented treatments initiated by family physicians and 35.3% by specialists (level 1). Statins made up 78.2% of the total cost; the inadequate expenditure for this therapeutic group reached $US88,797 (level 1). Of the prescriptions for fibrates, 88% were inadequate (level 1). CONCLUSIONS: In this study, 67% of prescriptions for hypolipidaemic medicines were ordered inadequately in the pensioner population, which represents a considerable pharmacological expenditure. This percentage and the mean cost per inadequate prescription was higher if a specialist was the professional initiating the treatment. Therefore, it is necessary to run pharmaceutical prescription quality programmes with both primary care physicians and specialists involved.
Authors: J A Lomeña Villalobos; M Ceballos Vacas; M T Medina Arteaga; E Mediavilla Cordero; F Sarmiento Jiménez; J L Hernández Grande Journal: Aten Primaria Date: 1996-06-15 Impact factor: 1.137
Authors: S Castán Cameo; F J García Latorre; J Martínez Gorostiaga; M J Sierra Moros; V M Solano Bernad; A Peral Casado Journal: Rev Esp Salud Publica Date: 1998 Jan-Feb
Authors: T Sanz Cuesta; E Escortell Mayor; M I Fernández San Martín; C López Bilbao; B Medina Bustillo; C Torres Bouza Journal: Aten Primaria Date: 2000-10-15 Impact factor: 1.137
Authors: H M Krumholz; T E Seeman; S S Merrill; C F Mendes de Leon; V Vaccarino; D I Silverman; R Tsukahara; A M Ostfeld; L F Berkman Journal: JAMA Date: 1994-11-02 Impact factor: 56.272