Abstract
BackgroundStudies 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.
Highlights
Over the last century, advances in medical therapeutics have contributed to improve global health and to increase life expectancy
Among the major determinants of drug prescription, studies suggested the role of geographical differences
Such variations may be dependent upon differences in the prescribing habits of general practitioners (GPs) and socioeconomic status of patients (Odubanjo et al, 2004)
Summary
Advances in medical therapeutics have contributed to improve global health and to increase life expectancy. Appropriate prescription of medications is one of the most important components of healthcare It reflects the accuracy of the diagnosis, adherence to evidence-based guidelines, and susceptibility to drug-marketing and regulatory factors. Scholars have shown that drug use varies across regions in Europe and the USA by more than would be expected based on population age and health status alone (Couto et al, 2014; Nolte and Corbett, 2015) Such variations may be dependent upon differences in the prescribing habits of general practitioners (GPs) and socioeconomic status of patients (Odubanjo et al, 2004). Studies have emphasized the importance of geographical factors and general practitioner (GP) characteristics in influencing drug prescriptions
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