Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2012 Nov 6;184(16):E852-6.
doi: 10.1503/cmaj.120465. Epub 2012 Sep 4.

Effect of a centralized prescription network on inappropriate prescriptions for opioid analgesics and benzodiazepines

Colin R Dormuth  1 , Tarita A Miller, Anjie Huang, Muhammad M Mamdani, David N Juurlink; Canadian Drug Safety and Effectiveness Research Network
Collaborators, Affiliations
Comparative Study

Effect of a centralized prescription network on inappropriate prescriptions for opioid analgesics and benzodiazepines

Colin R Dormuth et al. CMAJ. .

Abstract

Background: Opioid analgesics and benzodiazepines are often misused in clinical practice. We determined whether implementation of a centralized prescription network offering real-time access to patient-level data on filled prescriptions (PharmaNet) reduced the number of potentially inappropriate prescriptions for opioids and benzodiazepines.

Methods: We conducted a time series analysis using prescription records between Jan. 1, 1993, and Dec. 31, 1997, for residents of the province of British Columbia who were receiving social assistance or were 65 years or older. We calculated monthly percentages of filled prescriptions for an opioid or a benzodiazepine that were deemed inappropriate (those issued by a different physician and dispensed at a different pharmacy within 7 days after a filled prescription of at least 30 tablets of the same drug).

Results: Within 6 months after implementation of PharmaNet in July 1995, we observed a relative reduction in inappropriate filled prescriptions for opioids of 32.8% (95% confidence interval [CI] 31.0%-34.7%) among patients receiving social assistance; inappropriate filled prescriptions for benzodiazepines decreased by 48.6% (95% CI 43.2%-53.1%). Similar and statistically significant reductions were observed among residents 65 years or older.

Interpretation: The implementation of a centralized prescription network was associated with a dramatic reduction in inappropriate filled prescriptions for opioids and benzodiazepines.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Monthly percentages of filled prescriptions for opioid analgesics and benzodiazepines deemed inappropriate among residents of British Columbia receiving social assistance before and after the implementation of PharmaNet, a centralized prescription network. The dashed and dotted lines shown after the implementation of PharmaNet represent the predicted percentages and their 95% confidence intervals had the system not been implemented. (The method for calculating the overall change in inappropriate filled prescriptions during the 30-month period following implementation of the prescription network is described in the Methods section.)
Figure 2:
Figure 2:
Monthly percentages of filled prescriptions for opioids and benzodiazepines deemed inappropriate among residents of British Columbia 65 years of age or older before and after the implementation of PharmaNet. The dashed and dotted lines shown after the implementation of PharmaNet represent the predicted percentages and their 95% confidence intervals had the system not been implemented. (The method for calculating the overall change in inappropriate filled prescriptions during the 30-month period following implementation of the prescription network is described in the Methods section.)
Figure 3:
Figure 3:
Monthly percentages of filled prescriptions for nonsteroidal anti-inflammatory drugs deemed inappropriate among residents of British Columbia 65 years of age or older and residents receiving social assistance during the study period.
See this image and copyright information in PMC

Comment in

References

    1. Hsiao CJ, Burt CW, Rechtsteiner E, et al. Preliminary estimates of electronic medical records use by office-based physicians: United States, 2008. Natl Health Stat Report 2008. Available: www.cdc.gov/nchs/data/hestat/physicians08/physicians08.htm (accessed 2012 Feb. 2).
    1. Hing E, Hall MJ, Ashman JJ. Use of electronic medical records by ambulatory care providers: United States, 2006. Natl Health Stat Report 2010;Apr. 30:1–21 - PubMed
    1. Appari A, Carian EK, Johnson ME, et al. Medication administration quality and health information technology: a national study of US hospitals. J Am Med Inform Assoc 2012;19:360–7 - PMC - PubMed
    1. Aspden P, Wolcott JA, Bootman JL, et al., editors. Preventing medication errors. Washington (DC): National Academy Press; 2007. p. 409–46
    1. Kurdyak P, Gomes T, Yao Z, et al. Use of other opioids during methadone therapy: a population-based study. Addiction 2012; 107:776–80 - PubMed

Publication types

MeSH terms