Little is known about the effects of regulatory surveillance on quality of prescribing. Although previous research has found substantial reductions in BZ prescribing and increases in undesireable substitute medications, no study has assessed prescribing appropriateness. Using a segmented time series with comparison-series quasi-experimental design, we evaliuated changes in BZ prescribing overall and by demographic subgroups in equivalently defined adult medicaid cohorts in New York and New jersey (control) in rsponse to triplicate prescription program (TPP) implementation. We also examined changes in prescribing of potential substitute drugs and measures of potential problematic BZ prescribing. We found that the TPP caused a sudden, sustained 56% reduction in BZ prescribing, with significantly higher reductions among young AFDC women, in urban areas, and for persons residing in black communities. There were transient increases in prescribing of other anxiolytics and sedating antihistamines, but the only sutained substitution was a doubling in prescribing of older, less effective sedatives. There was no evidence of improvement in the appropriateness indicators. The TPP dramatically reduced BZ prescribing, but the only lasting substitution effect was to a less desireable class of sedative-hypnotic drugs. Although reducing use and cost, surveillance may not increase overall BZ prescribing quality.
Learning Objectives: 1. To examine the impact of a monitoring program on benzodiazepine use. 2. To understand how BZ regulation can affect appropriateness of BZ prescribing patterns. 3. To examine how BZ regulation may impact potential substitution of other less desireable medications
Keywords: Access to Care, Prescription Drug Use Patterns
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.