Background Drug therapy represents a major portion of healthcare spending. Drug utilisation research contributes to optimise drug policies in a rational drug use context.
Purpose To analyse PQI results in our centre and to identify new strategies in order to reinforce its compliance.
Material and methods Descriptive study based on the information arising from the PQI results from November 2015 to October 2016 compared to the previous two years. PQI is a tool proposed by our healthcare service (HCS) in order to establish a qualitative and quantitative assessment of drug prescribing. The index includes 14 items for specific improvement objectives for different therapeutic areas, and they are weighted according to their importance in global pharmaceutical spending (optimal 10 points, minimum 5). Data on defined daily dose (DDD) and prescriptions (number, cost, medical department) were retrieved from the Microstretegy® assistance application.
Results From November 2013 to October 2014, our centre scored 6.71 (HCS average 4.83), from November 2014 to October 2015, 4.72 (4.83) and from November 2015 to October 2016 2.54 (2.37). Due to the evident decline,an in-depth analysis it was imperative to reverse this trend. Analysis showed an imbalance when data were broken down by medical department. Most of the medical departments achieved a minimum score of 5 points at PQI, but they did not reach minimum score for those items with higher impact in their pharmaceutical consumption. Comparing the data between November 2014 to October 2015 and November 2015 to October 2016, we observed poorer results for the following items (therapeutic group (treatment of choice)): second-line antihyperglycaemic therapies (glicazide,glipizide,glimepiride); insulin treatment (intermediate and biphasic); lipid lowering medication (simvastatin); high-blood pressure medication (angiotensin-converting-enzyme inhibitor ±tiazides and angiotensin-II-receptor-antagonists losartan ±tiazides); and antidepressants (selective serotonin reuptake inhibitors). Endocrinology, cardiology and mental health medical departments were responsible for the low scores in those items. Consequently, a programme was designed and implemented to ensure the achievement of the PQI objectives: medical departments will have to comply with only 3/14 items from the PQI, and those who represent ≥80% overall DDD consumption in their department. Scores are now regularly reviewed in order to identify possible deviations and take the actions necessary to correct them. First results are reported as positive (August 2017, 2.88), particularly in the cardiology department.
Conclusion Analysis of PQI results is essential to adapt the specific improvement objectives to the medical units, in order to grant a sustainable high-quality public health system.
No conflict of interest
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