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Prescribing patterns and drug costs: Effects of formulary recommendations and community pharmacists' information campaigns

机译:处方模式和药物成本:处方建议和社区药剂师宣传活动的影响

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In the health care districts of Lund and Orup (Lund‐Orup) in southern Sweden, prescription recommendations for both primary and secondary health care are made by one local formulary committee. A revised formulary was introduced in 1989, and information on the most important changes was distributed to all prescribing physicians in the area with the new formulary. In an information campaign aimed only at district physicians (general practitioners) in Lund‐Orup, community pharmacists initiated and maintained verbal discussions on the changed recommendations, particularly those concerning low‐price brands of erythromycin, doxycycline, naproxen and combined amiloride/hydrochlorothiazide. One year and two years later they supplied feedback on compliance with the recommendations. Other prescribers in Lund‐Orup received written information on the formulary changes but no verbal information.Prescription surveys during that time indicated that the district physicians had rapidly accepted the new guidelines; compared with the other physicians they showed greater increases in prescription volume of the recommended low‐price brands and higher compliance rates with the recommendations. The overall cost reduction for the four preparations during 1989–91 was approximately SEK3m,* of which almost 25 per cent (SEK700,000) was attributable to the extra savings due to the higher compliance rates among district physicians. Not only do these figures exceed the costs of the information campaign; there was a return in reduced costs of several times the investment. It appears that a verbal information campaign providing district physicians with data on formulary recommendations and savings is a realistic means of reducing drug
机译:在瑞典南部的隆德和奥鲁普(Lund-Orup)卫生保健区,初级和二级卫生保健的处方建议由一个地方处方委员会提出。1989年引入了修订后的处方集,并将有关最重要变化的信息分发给该地区所有开处方的医生。在一项仅针对隆德-奥鲁普地区医生(全科医生)的宣传运动中,社区药剂师发起并保持了对修改后的建议的口头讨论,特别是那些涉及低价红霉素、多西环素、萘普生和阿米洛利/氢氯噻嗪复方品牌的建议。一年和两年后,他们提供了关于遵守建议的反馈意见。Lund-Orup的其他处方者收到了有关处方集变化的书面信息,但没有口头信息。在此期间的处方调查表明,地区医生迅速接受了新的指南;与其他医生相比,他们显示出推荐的低价品牌的处方量增加更多,对建议的依从率更高。在1989-91年期间,这四种制剂的总成本降低了约300万瑞典克朗,*其中近25%(700,000瑞典克朗)归因于地区医生的依从率较高而节省的额外费用。这些数字不仅超过了宣传活动的费用;成本降低的回报是投资的几倍。看来,向地区医生提供有关处方建议和节省的数据的口头宣传运动是减少药物的现实手段

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