4003.0: Tuesday, November 14, 2000 - 9:14 AM

Abstract #9254

Overview of the New York triplicate prescription program and its impact on benzodiazepine utilization and prescribing appropriateness

Stephen Soumerai, ScD1, Dennis Ross-Degnan, ScD1, Linda Simoni-Wastila, PhD2, Xiaoming Gao1, Jeffrey Brown, MA2, Connie Mah1, Leon Cosler, PhD3, Thomas Fanning3, Peter Gallagher3, Carl Salzman, MD1, Richard Platt, MD1, and Tom Inui, MD1. (1) Department of Ambulatory Care and Prevention, Harvard University, 126 Brookline Avenue, Suite 200, Boston, MA 02215, 617-421-6863, soumerai@warren.med.harvard.edu, (2) Schneider Institute for Health Policy, Brandeis University, MS 035, 415 South Street, Waltham, MA 02454-9110, (3) Office of Medicaid Management, New York Department of Health, Empire State Plaza, Corning Tower, 2oth Floor, Room 2053, Albany, NY 12237

Little is known about the effects of regulatory surveillance on quality of rpescribing. Benzodiazepines (BZ) are generally safe, effective, and widely used in treating anxiety, insomnia, seizure disorders, and other conditions. However, BZ are also assoiciated with habituation, abuse, and injury. In January 1989, New York added BZ to an existing Triplicate Prescription Program (TPP) for controlled substances, under which prescriptions are ordered on multiple copy prescription forms, with one copy sent to a state surveillance unit. This policy was intended to reduce BZ diversion and abuse, as well as to reduce inappropriate prescribing, without affecting legitimate medical use. Previously conducted research, although methodologically flawed, has shown substantial reductions in BZ prescribing and increases in undesireable substitute medications. No study to date has assessed appropriateness of BZ prescribing. Using a segmented time-series analytic approach, we examine changes in BZ prescribing, overall, by demographic subgroups, and by vulnerable clinical groups. We also examine changes in the prescribing of potential substitute drugs, and assess the impact of the TPP on indicators of ptoentially problematic BZ prescribing.

Learning Objectives: 1. To understand the implications of using a triplicate prescription program (TPP) to monitor drug utilization. 2. To examine how the New York TPP impacted BZ utilization. 3. To understand weaknesses and gaps of other studies, and how the presented study improves upon past research

Keywords: Prescription Drug Use Patterns, Access to Health Care

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.

The 128th Annual Meeting of APHA