Background Our public healthcare system has 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 variability of prescription QI in a public healthcare system, and its evolution per year.
Material and methods Descriptive retrospective observational study. Variability of QI in hospitals with more than 500 beds from 2012 to 2015 was measured.
The unit of measure was defined daily doses (DDD) using QI based on the rational use of medicines criteria.
QI included:%omeprazole DDD/DDD proton pump inhibitors (PPIs) (QI1),%DDD gliclazide+glipizide+glimepiride/DDD antidiabetics excluding insulin and metformin (QI2),%DDD intermediate insulins+biphasic/DDD insulins excluding fast (QI3),%DDD simvastatin/DDD lipid lowering drugs (QI4),%DDD ACE inhibitors/DDD renin-angiotensin-aldosterone system inhibitors (QI5),%DDD SSRIs/DDD second generation antidepressants (QI6),%DDD citalopram+fluoxetine+sertraline/DDD SSRIs (QI7) and%DDD alendronic/DDD fracture prevention drugs (QI8).
The coefficient of variation allowed us to compare variability in QI between hospitals during the study period.
Results 13 hospitals were studied. Data obtained are reported in table 1.
There was a high variability in prescription QI between studied hospitals which increased over the years, especially in diabetes and drugs for hip fracture prevention.
In groups of PPIs and antidepressants. variability was smaller.
Conclusion In therapeutic groups where new drugs have been incorporated (diabetes and fracture prevention), the uncertainty and degree of confusion in the management of these drugs increased.
To reduce clinical variability among different hospitals and improve the quality of prescription, it would be necessary to design and implement new strategies.
No conflict of interest.
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