Georg Heinze1, Lisanne M Jandeck1, Milan Hronsky1, Berthold Reichardt2, Christoph Baumgärtel3, Anna Bucsics4,5, Marcus Müllner3,6, Wolfgang C Winkelmayer7,8. 1. Section for Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria. 2. Sickness Fund Burgenland, Burgenländische Gebietskrankenkasse, Eisenstadt, Austria. 3. Austrian Agency for Health and Food Safety, Vienna, Austria. 4. Main Association of the Austrian Social Security Institutions, Vienna, Austria. 5. Department of Finance, University of Vienna, Vienna, Austria. 6. PERI Change GmbH, Vienna, Austria. 7. Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA, USA. 8. Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Abstract
PURPOSE: Double medication is defined as the unintended overlapping prescription of two identical substances with the same route of administration by two different prescribers to the same patient. Consequences of double medication are reduced patient safety and excess healthcare costs. Based on nationwide prescription data from 2011 covering 97% of Austria's population, we estimated double medication prevalences for treatment of hypertension, hyperlipidemia, and diabetes mellitus. METHODS: We investigated prescriptions of 88 antihypertensive, 16 lipid-lowering and 29 hypoglycemic substances in 7,971,323 persons in 2011. Prevalence of double medication was calculated patientwise (prevalence by patients) and timewise (prevalence by patient-years). Risk factors for double medication were identified by logistic regression. RESULTS: For antihypertensive, lipid-lowering, and hypoglycemic subtances, overall 15.0% (men: 15.1%, women: 15.0%), 13.1% (13.7%, 12.5%), and 13.0% (13.0%, 13.4%) of patients were doubly medicated, respectively. Corresponding prevalences by patient-years were 1.6%, 2.0%, and 1.2%. Logistic regression confirmed lower age and copayment waiver as independent risk factors of double medication. Furthermore, double medication occurred more often with prescriptions from hospitals or internal medicine specialists compared with general practitioners, as well as in August compared with earlier or later in the calendar year. CONCLUSION: While appropriate care or comanagement of patients by internal medicine specialists and general practitioners may explain some of the double prescriptions, our data indicate that unintended double medication is frequent. In Austria, lack of financial incentives of patients to avoid filling duplicate prescriptions explains a considerable fraction of double medication occurrences.
PURPOSE: Double medication is defined as the unintended overlapping prescription of two identical substances with the same route of administration by two different prescribers to the same patient. Consequences of double medication are reduced patient safety and excess healthcare costs. Based on nationwide prescription data from 2011 covering 97% of Austria's population, we estimated double medication prevalences for treatment of hypertension, hyperlipidemia, and diabetes mellitus. METHODS: We investigated prescriptions of 88 antihypertensive, 16 lipid-lowering and 29 hypoglycemic substances in 7,971,323 persons in 2011. Prevalence of double medication was calculated patientwise (prevalence by patients) and timewise (prevalence by patient-years). Risk factors for double medication were identified by logistic regression. RESULTS: For antihypertensive, lipid-lowering, and hypoglycemic subtances, overall 15.0% (men: 15.1%, women: 15.0%), 13.1% (13.7%, 12.5%), and 13.0% (13.0%, 13.4%) of patients were doubly medicated, respectively. Corresponding prevalences by patient-years were 1.6%, 2.0%, and 1.2%. Logistic regression confirmed lower age and copayment waiver as independent risk factors of double medication. Furthermore, double medication occurred more often with prescriptions from hospitals or internal medicine specialists compared with general practitioners, as well as in August compared with earlier or later in the calendar year. CONCLUSION: While appropriate care or comanagement of patients by internal medicine specialists and general practitioners may explain some of the double prescriptions, our data indicate that unintended double medication is frequent. In Austria, lack of financial incentives of patients to avoid filling duplicate prescriptions explains a considerable fraction of double medication occurrences.
Authors: D Wucherer; J R Thyrian; T Eichler; J Hertel; I Kilimann; S Richter; B Michalowsky; I Zwingmann; A Dreier-Wolfgramm; C A Ritter; S Teipel; W Hoffmann Journal: Int Psychogeriatr Date: 2017-08-07 Impact factor: 3.878
Authors: Wolfgang Umek; Andreas Gleiss; Barbara Bodner-Adler; Berthold Reichardt; Christoph Rinner; Georg Heinze Journal: Pharmacoepidemiol Drug Saf Date: 2019-12-05 Impact factor: 2.890