Table_3_Geographical Variation in Medication Prescriptions: A Multiregional Drug-Utilization Study.docx
Studies have emphasized the importance of geographical factors and general practitioner (GP) characteristics in influencing drug prescriptions.
ObjectivesTo: (i) ascertain the prevalence rate (PR) of use of drugs in six therapeutic categories used for chronic conditions; (ii) assess how geographical characteristics and GP characteristics may influence drug prescribing.
MethodsThis study is part of the EDU.RE.DRUG Project, a national collaborative project founded by Italian Medicine Agency (AIFA). Cross-sectional analyses were undertaken employing the pharmacy-claim databases of four local health units (LHUs) located in two Italian regions: Lombardy and Campania. Six drug categories were evaluated: proton-pump inhibitors; antibiotics; respiratory-system drugs; statins; agents acting on the renin−angiotensin system; psychoanaleptic drugs. The PR was estimated according to drug categories at the LHU level. A linear multivariate regression analysis was undertaken to evaluate the association between the PR and geographical area, age and sex of GPs, number of patients, and percentage of patients aged >65 per GP.
ResultsLHUs in Campania showed a PR that was significantly higher than that in Lombardy. Antibiotics showed the highest PR in all the LHUs assessed, ranging from 32.5% in Lecco (Lombardy) to 59.7% in Naples-2 (Campania). Multivariate linear regression analysis confirmed the association of the PR with geographical area for all drug categories. Being located in Campania increased the possibility of receiving a drug prescription from the categories considered, with estimates more marked for antibiotics, proton-pump-inhibitors, and respiratory-system drugs.
ConclusionsThis study provides information about the PR of medications used for treating common and costly conditions in Italy and highlighted a significant geographical variation. These insights could help to develop area-specific strategies to optimize prescribing behavior.
History
References
- https://doi.org//10.1111/j.1752-8062.2008.00003.x
- https://doi.org//10.1097/00002800-199911000-00012
- https://doi.org//10.1186/1471-2466-11-48
- https://doi.org//10.1016/j.numecd.2013.04.002
- https://doi.org//10.1855/jmcp.2014.20.8.834
- https://doi.org//10.1186/s12889-017-4905-4
- https://doi.org//10.1371/journal.pone.0000592
- https://doi.org//10.1007/s00228-013-1495-7
- https://doi.org//10.3892/mmr.2012.818
- https://doi.org//10.1186/s12875-016-0460-9
- https://doi.org//10.1155/2015/542183
- https://doi.org//10.1155/2016/8062079
- https://doi.org//10.1007/s40520-013-0127-5
- https://doi.org//10.11138/ccmbm/2016.13.2.127
- https://doi.org//10.2147/PPA.S164819
- https://doi.org//10.3399/bjgp09X395076
- https://doi.org//10.2165/00023210-200216020-00003
- https://doi.org//10.1111/j.1365-2125.2004.02179.x
- https://doi.org//10.2147/RMHP.S223042
- https://doi.org//10.1016/j.healthpol.2009.12.005
- https://doi.org//10.1007/s00228-011-1204-3
- https://doi.org//10.1007/s00228-013-1615-4.
- https://doi.org//10.1186/s12905-017-0424-9
- https://doi.org//10.2147/CEOR.S161299
- https://doi.org//10.1186/s12913-016-1411-9
- https://doi.org//10.1097/00005650-200308000-00004