Background The Andalusian Public Health Care Service have developed some indicators based on the selection of drugs for which there is better evidence of efficiency within several therapeutic groups, in areas of prescribing in which more deviations were detected in the past.
Purpose To improve the prescribing in a rheumatology team, in terms of efficiency, through the implementation of three quality prescribing indicators, and to measure its degree of compliance after completion of an educational program.
Materials and methods Retrospective observational study that measures the percentage of prescriptions meeting three quality indicators before and after an educational program consisting of clinical sessions, meetings with the head of the rheumatology team and/or meetings with medical direction and management direction. Doctors also had information on their results every three months. The three indicators measured were: percentage of generic-name prescriptions versus total prescriptions, percentage of first-line NSAIDs (naproxen, diclofenac and ibuprofen) prescribed versus total NSAIDs and percentage of alendronate, Calcium and Vitamin D versus total of drugs approved for fracture prevention. The prescription rates were measured in October 2012, before the beginning of the educational program, and in August 2013, when it had ended. Prescribing data were obtained from the pharmacy’s computerised reimbursed drugs records (Microstrategy) of all physicians who belonged to the rheumatology team for at least one month during the time studied.
Results The initial team of six doctors was monitored. At the end of the study no one had left and no new doctors were incorporated. Three clinical sessions were given by the pharmacist in charge, plus two meetings between him and the chief doctor, and another two between the pharmacist, Chief Doctor and Medical Director. Generic prescription was 72.02% at the beginning and had increased to 83.77% ten months later. First-line NSAIDs prescribing also increased from 18.23% to 46.06%, and the percentage of first-line drugs for fracture prevention (Ca, vit. D and alendronate) rose from 27.05% to 42.50% at the end of the study.
Conclusions Prescription of generic-name drugs, first-choice NSAIDs and first-line drugs for fracture prevention improved in a Rheumatology Unit due to an educational prescribing course based on clinical evidence guidelines. The initiative was popular with the doctors, and the commitment of the Medical Director was important to obtain these results.
No conflict of interest.
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