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DI-021 Improvement strategies in quality prescribing indicators on a healthcare area
  1. E Campos-Davila1,
  2. J Puerto-Alonso2,
  3. D Guerra Estévez1,
  4. JJ Ramos-Báez3,
  5. J Roldán-Morales1,
  6. F Araujo-Rodríguez1
  1. 1Hospital SAS La Linea, Pharmacy, La Linea de La Concepcion, Spain
  2. 2Hospital SAS Las Línea, Internal Medicine, La Línea de La Concepción, Spain
  3. 3Campo de Gibraltar Health Care Area, Pharmacy, Algeciras, Spain

Abstract

Background Our Public Healthcare Service have developed some quality indicators (QI) based on the selection of drugs that support better evidence of efficiency in areas of prescribing where more deviations were detected in the past.

Purpose To describe the strategies for improving the indicators, measuring compliance with them after three years and evaluating their financial impact on the public budget.

Material and methods Retrospective observational study. The percentage of prescriptions of three QIs (omeprazole versus total PPIs, simvastatin versus total lipid-lowering drugs and ACE inhibitors versus total renin-angiotensin-aldosterone-system inhibitors) was evaluated before and after an educational program consisting of clinical sessions, meetings with the head of medical team (HMT) and Medical Director, periodic written reports for doctors and interviews with low-compliance-rate doctors. Prescription rates were measured in March 2011 and February 2014. Prescribing data and financial impact were obtained from the reimbursed drugs Program (Microstrategy), which enabled us to calculate the possible savings if the optimal level of prescriptions were to be reached.

Results 24 clinical sessions were held in 2011, 17 in 2012 and 10 in 2013. Meetings with the HMT and Medical Director were biannual in 2011 and annual in 2012–13. 23 interviews were held, all in 2013. Reports were distributed in 100% of Units and possible periods. Omeprazole prescription was 69.3% at the beginning and increased to 85.4% three years later. Simvastatin prescribing also increased from 18.07% to 40.4%, and the percentage of ACE inhibitors rose from 28.44% to 52.82%. Regarding cost savings, in March 2011 drug expenditure in our Healthcare Area was €244, 717 more than with the theoretical optimum level of prescription, but in February 2014, this excess had reduced to just €44,803.

Conclusion The strategies adopted were well received by the doctors, resulting in a considerable improvement of the indicators evaluated. This improvement now produces direct annual savings of €200,000 in the public budget in our Healthcare Area compared to three years ago.

References and/or acknowledgements No conflict of interest.

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