Prescription Audit Research Articles

Utilizing IT-supported precision management measures to enhance rational drug use in primary healthcare institutions: a study of an internet-based regional prescription audit center

This study aimed to elevate the qualified rate (QR) of prescriptions and improve rational drug use while also minimizing adverse drug events in primary healthcare institutions within a designated region through information technology (IT)-supported precision management.In this study, a retrospective analysis was performed to evaluate the changes in the QR and adverse event rate associated with 5,923,764 prescriptions across 13 community health service centers in Tianhe District, Guangzhou, Guangdong Province, before and after the implementation of IT support. Detailed records and analyses were conducted on specific psycho-narcotic drugs, the appropriate use of antimicrobial prescriptions, and the incidence of adverse events following the introduction of IT support.Following the IT-supported precision management, 13 community health service centers witnessed a notable surge in the average QR of prescriptions, rising from 91.90% to 96.97% from 2018 to 2021 (P < 0.05). Among this, the average QR of psychotropic and anesthetic drugs, as well as antibiotics prescriptions at the same center showed a significant increase, while the average utilization rate of antibiotics demonstrated a marked decrease. Furthermore, the average incidence rate of adverse events caused by high-alert drugs dwindled from 225 cases/year in 2020 to 109 cases/year in 2021.The integration of a regional remote prescription audit center for IT-supported precision management of drug use in primary healthcare institutions has improved prescription quality and diminished the incidence rate of adverse drug events, indicating a significant contribution to the distribution of high-quality pharmacy resources of Grade IIIA hospitals to primary healthcare institutions. This initiative also improves rational drug use, marking a pioneering innovation in pharmacy practice that deserves commendation.

367. Enhancing antimicrobial stewardship capacity building and communication across multidisciplinary departments in Chinese hospitals: a national qualitative study

Abstract Background Antimicrobial stewardship (AMS) programs have been widely adopted and proven to be effective to optimize antibiotic use. After a decade of efforts in mandatory AMS implementation, inappropriate prescribing and antimicrobial resistance are still disproportionately prevalent in China. We aim to investigated the underlying barriers to the mandatory AMS programs from a multidisciplinary health system perspective in the Chinese context. Example of quotes from interview transcripts that illustrate and validate the themes Methods Face-to-face, in-depth qualitative interviews were conducted in 16 public hospitals in eastern, central, and western China. Hospitals were purposely selected with full consideration to represent both economically developing and developed areas and both secondary and tertiary care hospitals. A total of 111 respondents were interviewed, including 38 doctors, 28 clinical pharmacists, 15 microbiologists, 14 infection prevention and control (IPC) specialists, 10 experts from medical service departments, and 6 quality improvement experts. A thematic framework analysis was conducted aided by NVIVO 11 software. Example of quotes from interview transcripts that illustrate and validate the themes (continue) Results Our research identified two key barriers to AMS implementation. 1) Inadequate AMS-related capacities among doctors and nurses. Doctors, especially surgeons, had inadequate knowledge and poor practices on appropriate antibiotic use and had insufficient knowledge and skills in antimicrobial susceptibility testing (AST) and its interpretation. The continuing education in a few hospitals was reported to be crammed with large class sizes and showed little effect on capacity improvement. 2) Poor communication and cooperation between the AMS team and doctors. Compared with AMS team members, doctors had a dominant and powerful position in hospitals. Clinical pharmacists admitted that they were subjected to high pressure and not well respected while conducting routine prescription audit and feedback works. Most (87%) of the interviewed microbiologists were not able to access the electronic health records. Conclusion We propose a multi-disciplinary training program covering microbiology, clinical pharmacy, and IPC for newly-recruited health workers (i.e., doctors and nurses), and a communication mechanism among clinical departments and AMS members to facilitate AMS implementation. Disclosures All Authors: No reported disclosures

P-1690. The relationship of prescriber role and timing of prescribing to antibiotic prescribing appropriateness at a tertiary academic hospital

Abstract Background There are limited studies examining antibiotic prescription appropriateness that compare trainees versus attending physicians or time of prescription in relation to working hours. Antimicrobial stewardship (AMS) prospective audit and feedback (PAF) was implemented in 2018 at a tertiary care centre targeting six restricted antibiotics (carbapenems, daptomycin, linezolid, and tigecycline). The agent, regimen, and duration were assessed by AMS pharmacists and/or physicians against institutional prescribing guidelines (expert opinion if not available) and recorded prospectively in the AMS quality improvement database. Real time written and verbal feedback were provided to the most responsible physician. Table 1 Baseline prescription demographics. Methods We examined all prescriptions subjected to PAF from 2018 to 2023, with the primary objective to assess prescription appropriateness for medical trainees versus staff physicians. Secondary objectives were to evaluate whether other variables including time of day (working vs off hours), weekday vs weekend, and the COVID-19 pandemic period (Mar 2020-May 2022) impacted appropriateness. Multiple logistic regression was used to determine factors independently associated with optimal prescribing of antibiotics. Institutional ethics approval was obtained. Figure 1 Odds ratios of prescription appropriateness for each independent variable (reference in parentheses). Results Overall, 3685 prescription audits were included in this study. Baseline prescription demographics are shown in Table 1. Of these, 1106 (32%) audited prescriptions were assessed by AMS PAF as not optimally prescribed requiring actionable AMS intervention. Prescriptions written by trainees were not less appropriate compared to staff (OR 1.27 [95%CI 0.97-1.66]). Off hours prescriptions had lower odds of being optimal (OR 0.81 [0.64-1.02], NS). Other secondary outcomes are reported in Figure 1. Prescriptions initiated by infectious disease (ID) had higher odds of being optimal (4.88 [3.68-6.55]). Conclusion In our cohort, we did not find a difference in appropriateness of restricted antibiotic prescriptions between trainees and staff, with a trend towards decline in optimal prescribing during off hours and weekends. ID had higher odds of optimally prescribing. Appropriateness improved over time and the COVID-19 pandemic did not have a negative effect at our center. Disclosures All Authors: No reported disclosures

Longitudinal Analysis of Obesity Drug Use and Public Awareness.

Obesity, a chronic disease with escalating global prevalence, poses considerable health risks. Glucagon-like peptide 1 receptor agonists (GLP-1RAs), including liraglutide, semaglutide, and tirzepatide, have demonstrated efficacy for weight loss in clinical trials. The paradigm shift in the approach to obesity management drugs (OMDs) may offer an opportunity to examine online search activity and prescription trends. To investigate prescription patterns and online search trends for OMD and correlating usage dynamics with public engagement regarding these medications. This repeated cross-sectional study analyzed online searches and corresponding data for dispensed prescriptions derived from the IQVIA National Prescription Audit, a comprehensive audit capturing approximately 90% of US retail prescription dispensing that is then projected to population-level data. Data from online searches and on prescriptions from the National Prescription Audit for US Food and Drug Administration-approved OMDs were collected from July 1, 2017, through February 29, 2024. This population-level analysis included all eligible individuals using either the Google search engine or receiving prescriptions. US monthly query fractions as online searches per 10 million total searches and monthly prescriptions dispensed for OMDs. Trends in OMD prescriptions and online searches were visually analyzed, and quantitative correlations were calculated using Spearman rank correlation. During the study period, 69 213 936 prescriptions for OMDs were dispensed in the US, with an overall increase of 0.76 to 0.80 million from July 2017 to June 2018 and 1.29 to 1.51 million from March 2023 to February 2024 and a mean (SD) annual growth rate of 5.3% (9.4%). Total monthly OMD prescriptions reached 1.5 million in February 2024, accounting for 0.41% of all prescriptions that month. Phentermine, semaglutide (Wegovy; Novo Nordisk), liraglutide (Saxenda; Novo Nordisk), and tirzepatide (Zepbound; Eli Lilly) were most prescribed. By February 2024, phentermine had approximately 0.74 million monthly prescriptions, Wegovy had 0.42 million, and Zepbound had 0.25 million. Most prescriptions were issued by advanced practice practitioners (APP) and primary care physicians (PCPs) and internists. The APPs' share increased from 25.3% in July 2017 to 40.6% in February 2024, while PCPs' and internists' share decreased from 57.9% to 48.1%. Wegovy's share of total OMDs increased to 27.7% and 28.3% and Zepbound's share to 16.1% and 16.5% (both February 2024) among APPs and PCPs and internists, respectively. Phentermine's dropped from 86.3% and 85.1% (July 2017) to 50.8% and 49.7% (February 2024), respectively. Online searches per 10 million reflected prescription trends, with Wegovy at 636.3, Zepbound at 468.9, and phentermine at 301.8 (all February 2024). The strongest correlations between prescriptions and search volumes were observed for semaglutide (Wegovy; r = 0.97) and tirzepatide (Zepbound; r = 0.90). This repeated cross-sectional study shows the dynamic growth and evolving share of new obesity medications since 2017 and a significant shift toward semaglutide and tirzepatide prescribing. The joint surge in prescriptions and online searches and their close correlation highlight the real-time associations between public awareness and prescription trends.

Medication Management Process: Some Key Challenges and the Way to Address Them

Abstract Medications are essential in the patient healing process within hospital settings; however, their management is fraught with challenges that can lead to adverse outcomes when not handled properly. This study delineates the key phases of medication management—selection and procurement, storage, prescribing, dispensing, administration, and monitoring—while emphasizing the complexities and potential pitfalls within each phase. Major obstacles identified include a lack of accountability across departments, improper storage conditions, and the prevalence of medication errors and near misses. Effective strategies to mitigate these risks are proposed, such as establishing a prescription audit team, minimizing verbal orders, and ensuring thorough reviews of patient medication charts by specialists. This research advocates for a multidisciplinary approach involving collaboration among healthcare professionals, particularly the pharmacy team, to enhance medication safety and efficacy. By fostering clear roles and responsibilities within the medication management process, healthcare organizations can significantly reduce the incidence of medication-related errors, ultimately improving patient care outcomes.

Efficacy of quality improvement interventions on antibiotic prescription practices for ventilator-associated pneumonia at a tertiary care centre: a prospective pre–post interventional study

BackgroundVentilator-associated pneumonia (VAP) is a prevalent nosocomial infection in the intensive care unit (ICU), significantly increasing patient morbidity, mortality, and healthcare costs. Effective management is essential, particularly in the context...

Effect of a Feedback Visit and a Clinical Decision Support System Based on Antibiotic Prescription Audit in Primary Care: Multiarm Cluster-Randomized Controlled Trial.

While numerous antimicrobial stewardship programs aim to decrease inappropriate antibiotic prescriptions, evidence of their positive impact is needed to optimize future interventions. This study aimed to evaluate 2 multifaceted antibiotic stewardship interventions for inappropriate systemic antibiotic prescription in primary care. An open-label, cluster-randomized controlled trial of 2501 general practitioners (GPs) working in western France was conducted from July 2019 to January 2021. Two interventions were studied: the standard intervention, consisting of a visit by a health insurance representative who gave prescription feedback and provided a leaflet for treating cystitis and tonsillitis; and a clinical decision support system (CDSS)-based intervention, consisting of a visit with prescription feedback and a CDSS demonstration on antibiotic prescribing. The control group received no intervention. Data on systemic antibiotic dispensing was obtained from the National Health Insurance System (Système National d'Information Inter-Régimes de l'Assurance Maladie) database. The overall antibiotic volume dispensed per GP at 12 months was compared between arms using a 2-level hierarchical analysis of covariance adjusted for annual antibiotic prescription volume at baseline. Overall, 2501 GPs were randomized (n=1099, 43.9% women). At 12 months, the mean volume of systemic antibiotics per GP decreased by 219.2 (SD 61.4; 95% CI -339.5 to -98.8; P<.001) defined daily doses in the CDSS-based visit group compared with the control group. The decrease in the mean volume of systemic antibiotics dispensed per GP was not significantly different between the standard visit group and the control group (-109.7, SD 62.4; 95% CI -232.0 to 12.5 defined daily doses; P=.08). A visit by a health insurance representative combining feedback and a CDSS demonstration resulted in a 4.4% (-219.2/4930) reduction in the total volume of systemic antibiotic prescriptions in 12 months. ClinicalTrials.gov NCT04028830; https://clinicaltrials.gov/study/NCT04028830.

A PROSPECTIVE, OBSERVATIONAL DRUG UTILIZATION STUDY IN THE DERMATOLOGY OUT-PATIENT DEPARTMENT OF A GOVERNMENT HOSPITAL, NANDYAL, ANDHRA PRADESH

Objective: The data regarding drug utilization in dermatology departments of southern parts of India is limited. Recent studies on drug utilization in dermatology across India, reported high prescription of branded drugs, low adoption of essential drugs and polypharmacy. Hence, this study was conducted to analyze the drug utilization pattern for common skin diseases as per WHO prescribing indicators. Methods: This study was done in the Out-patient department (OPD) of dermatology at Government General Hospital (GGH), Nandyal, in collaboration with department of Pharmacology for a period of 4 mo and Institutional ethical committee (IEC) permission was taken before conducting the study. Results: A total number of 344 prescriptions were analyzed. Average number of drugs per prescription was 2.5 (including Fixed drug combination (FDC) drugs). Total number of drugs accounted to 860. Majority of prescriptions have 3 drugs per prescription (57.1%) and only 8.7% of prescriptions have more than 3 drugs per prescription. Analyzed data as per World Health Organization (WHO) prescribing indicators indicate 74% of prescribed drugs were from National List of Essential Medicines (NLEM), 2.5% were FDC drugs and 13.14% of the drugs prescribed were antibiotics. Polypharmacy was noted to be only 0.7% in the study. Conclusion: A periodic audit of prescriptions will reduce errors and motivate the health care professionals for rational drug use. Special consideration is to be given to extended public health initiatives to prevent skin infections because they account for about 70% of diseases in daily life.

Antimicrobial stewardship implementation in primary and secondary tier hospitals in India: interim findings from a need assessment study using mixed method design

Anti-microbial stewardship program (AMSP) is practiced only in tertiary hospitals in India, though, the lower tier hospitals remain the first point of contact in patient care. This study was conducted in lower tier hospitals to calculate antibiotic and multiple antibiotic prescription rate (APR, MPR) for common infections and finding existing strength of health system for optimizing antibiotic prescription. We conducted a cross sectional convergent parallel mix-method study in eight lower tier hospitals of three districts of West Bengal, India. Six hundred OPD prescriptions of UTI, ARI, AUFI, ADD were evaluated. Qualitative data collected through in-depth interviews of medical officers/officers in administrative positions, infection control nurses were analyzed using content analysis method. APR was 63.8% in primary tier hospitals and 60.8% in secondary tier hospitals. The MPR was higher in secondary tier hospital (23.8%). Presence of infection control committee, designated nursing staff, initiation of prescription audit, increased monitoring were identified as few facilitators for future implementation of AMSP in lower tier hospitals. The routine infection control activities of lower tier hospitals are currently delinked from AMR containment measures and thus, customized AMSP needs to be established in these hospitals catering two third of the population of India.

PRESCRIPTION AUDIT AT A TERTIARY CARE HOSPITAL – A CROSS-SECTIONAL STUDY

Objective: The aim of this study was to analyze prescribing practices at Silchar Medical College and Hospital (SMCH) through a cross-sectional audit of 600 outpatient prescriptions, adhering to the National Health Mission Prescription Audit Guidelines 2021. Methods: The audit examined prescriptions of patients who visited the Outpatient department (OPD) of Department of General Medicine, Surgery, Orthopedics, Gynecology and Obstetrics, Pulmonary Medicine, Pediatrics, Dermatology, and Psychiatry. The audit evaluated key aspects such as the completeness of patient information, legibility of prescriptions, documentation of clinical details, and adherence to standard treatment guidelines (STG). Results: The prescription audit at SMCH revealed high compliance with essential criteria such as OPD registration and patient gender documentation. However, gaps were identified in areas such as allergy status documentation (0%), legible handwriting (75.7%), and follow-up advice (16.9%). In addition, adherence to STG was observed in 75% of prescriptions, with a concerning finding that there was a lack of facility’s Antibiotic Policy. Conclusion: The study underscores the importance of complete and accurate prescription documentation to ensure patient safety and effective treatment.

Study on antifungal usage in patients with vaginal itching and discharge at a private hospital in Kolkata using the National Accreditation Board for Hospitals and Healthcare Providers and the World Health Organization prescribing criteria

Abstract Introduction: One in every 10 women presents with abnormal vaginal discharge in Gynaecology and Obstetrics Department, with the most common cause being candidiasis. Irrational use of antifungal for treatment of this condition leads to antifungal resistance and increase morbidity. Materials and Methods: This retrospective study was conducted at the Department of Pharmacology in collaboration of Department of Obstetrics and Gynaecology of the private medical college hospital in Kolkata. One hundred and forty outpatient department prescriptions were screened and included in this study from March 2024 to April 2024, and the prescriptions of the previous 6 months were collected. Results: The average number of drugs per prescription was 1.1. Antifungals were prescribed in 89.3%, out of which only 8.6% were in accordance with the standard treatment guidelines of management of vaginal candidiasis. The dose of the drug was written in 11.5% of the prescriptions while the duration of treatment was written in 84.9% of the prescriptions. The fungal culture and sensitivity testing was documented in only 10.7% of the prescriptions. 29.5% of the prescriptions had the generic name of the medicines whereas the complete diagnosis was written in only 13.7% of the prescriptions. Conclusion: This study highlights the commonly encountered errors in prescribing of antifungal drugs in a tertiary care teaching hospital. These errors may lead to irrational prescribing of antifungal and development of antifungal resistance in the long run. Active surveillance in the form of regular prescription audit and organizing regular training workshop for the prescribers will improve the prescribing practice.

Analysis of the pattern of drug use using WHO core drug indicators among general OPD patients in rural Puducherry.

Prescription auditing is a crucial tool for evaluating a range of concerns, including injectable usage, polypharmacy, the use of generic names, and the quality of treatment given to patients in primary care facilities. The objective of the study was to assess, using WHO core drug use indicators, the drug use patterns of general outpatients (OPD) at a rural healthcare facility. A cross-sectional study was conducted in a rural peripheral health centre in Puducherry for a period of one year from September 2019 to August 2020. A total of 1200 prescriptions were analysed using the World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) monitoring tool to evaluate the prescription practices. Prescriptions of consenting patients attending OPD for general ailments were included in the study. Three to four prescriptions were chosen randomly on a daily basis. Patients who attended special clinics were excluded. The data was entered and analysed in MS Excel. The average number of drugs per encounter was 3.10. The number of drugs prescribed by generic name was 65.7% and 39.8% of the encounters had antibiotics prescribed. Around 23.0% of the prescriptions contained injections. Of the prescribed drugs, 97.4% were available in the essential drug list. The average dispensing time observed was 20.80 sec. Out of the 3723 drugs prescribed 92.2% were actually dispensed and 77.5% were adequately labelled. Out of the 1200 patients interviewed regarding the dosage 72.0% had knowledge regarding the correct dosage. The health centre had a copy of the essential drug list and 83.0% of the drugs were available from the key drug list. Many indicators had shown sub-optimal values when compared to the recommended ones by WHO/INRUD. Timely interventions like continuing medical education for budding physicians, improving the doctor-population ratio, adequate number of pharmacists in public health facilities will improve prescription practices which in turn may contribute to mitigating antimicrobial resistance.

Audit of antibiotic utilization patterns and practice for common eye infections at the ambulatory clinic of a teaching hospital in Ghana: Findings and implications

Background Antimicrobial resistance (AMR) is a serious public health issue which is exacerbated by increased inappropriate use of antibiotics for common eye infections. This cross sectional survey was to assess the appropriate use of antibiotics for eye infections in an ambulatory clinic in Ghana and possible determinants. Method The medical records of all patients who sought eye care between January 2022 to December 2022 and were prescribed antibiotics were extracted from the hospital’s electronic database. Descriptive, bivariate and multivariate analyses were then conducted. Results A total of 1925 patient medical records were extracted, whose median age was 40 years (IQR 26–69), and were mostly females (58.91%, n = 1134/1925). The eye condition commonly treated with antibiotics was bacteria conjunctivitis (33.51%, n = 645/1925). The most prescribed antibiotic was gentamycin (22.96%, n = 442/1925) followed by ciprofloxacin (16.78%, n = 321/1925). These were mostly topical dosage forms (82.13%, n = 1581/1925). Systemic antibiotics prescribed were mostly from the WHO ‘Access’ class (83.33%, n = 280/338). The appropriate choice of antibiotic prescribed was 42.44% (n = 817/1925) and this was positivity associated with age (p&lt;0.001), number of antibiotics prescribed (p &lt;0.001), the prescription of topical dosage forms (p &lt;0.001), and WHO ‘Access’ antibiotic class (p &lt;0.034). Conclusion The level of appropriateness of antibiotic prescriptions for eye infections was sub-optimal. Antimicrobial stewardship programs, including prescriber education on guidelines and prescription audit to address associated factors, must now be instigated in this hospital to improve future antibiotic use and prevent the rise of AMR.

A prescription audit in the ear, nose and throat outpatient department, in a tertiary care hospital: a descriptive cross-sectional study

Background: Prescription audit is a quality improvement process aimed at enhancing patient care and outcomes by reviewing prescriptions. It provides feedback to healthcare providers, (HCPs) to identify areas for improvement and ensure the quality of prescriptions. This study aims to analyse the prescription patterns and prescribing behaviour of doctors using world health organization (WHO) recommended core prescribing indicators and prescription audit guidelines from national health mission (NHM), India and implement action plan accordingly. Methods: A descriptive observational cross-sectional study was conducted for one month in the ear, nose and throat outpatient department (ENT OPD) of KMC-RI, Hubballi. A total of 96 prescriptions were analysed using WHO-recommended core indicators and additional indicators from a prescription audit template. An action plan was created to enhance prescription quality. Results: All the prescriptions contained complete demographic details of the patients, OPD registration name and date of consultation. Handwriting was legible in all 96 prescriptions with a score of 100%. Two lowest performing attributes were identified using prescription audit tool namely, allergy status and generic name with a score of 7% and 37.9% respectively. The study revealed that average number of drugs encountered was 1.9, the percentage of drugs prescribed by generic name was 37.9%, percentage of encounters with an injection prescribed was 2.08% and percentage of drugs prescribed from NLEM was 37.9%. Conclusions: The prescription audit revealed that most prescriptions adhered to WHO standards. However, improvements are needed in documenting allergy status and prescribing by generic name. An action plan with a defined timeline has been prepared to provide feedback, aiming to enhance prescription quality and ensure better healthcare outcomes.

Prescription Audit In Outpatient Department Of A Tertiary Care Teaching Hospital Of North India

Prescription Audit In Outpatient Department Of A Tertiary Care Teaching Hospital Of North India

Naloxone Dispensing to Youth Ages 10-19: 2017-2022.

Naloxone is lifesaving in the event of an opioid overdose but is underutilized in adolescents. Youth-serving clinicians can play a role in expanding naloxone access by offering it to all youth at risk for opioid-involved overdose, including by prescription. Understanding naloxone dispensing trends to youth can inform efforts to expand its use. We used IQVIA National Prescription Audit Patient Insights data, which contains prescriptions dispensed from ∽48 900 retail pharmacies, representing 93% of all prescriptions from all payers in the United States. Cross-sectional analyses were used to describe naloxone dispensing trends among youth ages 10 to 19 years over time and by patient sex, out-of-pocket cost, prescriber specialty, and payer. From 2017 to 2022, 59 077 prescriptions for naloxone were dispensed to youth ages 10 to 19. Dispensing rates increased 669%, from 6.6 to 50.9 prescriptions per 100 000 adolescents, with increases each year. Dispensing varied by specialty and sex. Pediatricians accounted for an increasing proportion of prescriptions dispensed with a 6-year increase of 991%. Seventy-four percent of prescriptions were paid through commercial insurance. Although most prescriptions dispensed had low to 0 cost-sharing, 20% had out-of-pocket costs exceeding $25, and over 6% had out-of-pocket costs exceeding $75. Pediatricians and other youth-serving clinicians can play an important role in expanding access to naloxone and harm reduction information by prescribing naloxone to all youth who are at risk for overdose. Clinician prescribing of naloxone can augment community distribution and over-the-counter access by making naloxone more widely available at all touchpoints with the health care system.

P026 A PRESCRIPTION TREND ANALYSIS OF ANTIHYPERTENSIVE PHARMACOTHERAPY ACROSS DIFFERENT SPECIALTIES IN INDIA

Objective: To evaluate the temporal trends in the prescription patterns of antihypertensive medications among healthcare practitioners in India. Methods: The IQVIA (formerly Quintiles and IMS Health) prescription audit data came from prescriptions of a panel of 6000 private sector primary care clinicians for the different classes of antihypertensive drugs; beta-blockers(BB), calcium channel blockers(CCB), angiotensin receptor blockers(ARB), angiotensin-converting enzyme(ACE) inhibitors, and diuretics were examined. The analysis encompassed the period from 2014 to 2022. Additionally, combinations of these drug classes involving two or three medications were also subject to analysis. Results: Cardiologists’ prescription rates for antihypertensive medications stood at 21% in 2017 and decreased to 19% by 2023. In 2023, the highest rate of prescribing antihypertensive drugs was observed among consultant physicians, with a rate of 30%, followed by general practitioners at 27%. In addition, during COVID-19, the prescription share of general practitioners was highest (31%). Among antihypertensive medications, the prescription rates for BBs were highest (32%), followed by ARBs &amp; CCBs (25% &amp; 24% respectively). Single-drug formulation of anti-hypertensive medications was the most preferred (60%) among Indian clinicians. Prescription shares of fixed-dose combinations (FDC) of two antihypertensive drugs showed a slight decline (36% in 2017 to 34% in 2023) &amp; FDCs of triple-drug exhibited an upward trend (3% in 2017 to 5% in 2023). Among the two drug FDCs, ARB &amp; diuretics were most preferred (25% prescription share) &amp; triple drug FDCs, CCB, ARB &amp; diuretics were most preferred. Conclusions: Cardiovascular medications are prominent in the Indian pharmaceutical market, with antihypertensives standing out as one of the most frequently prescribed treatments. Consultant physicians and general practitioners manage the majority of hypertension cases. Notably, there has been an observed rise in preference for triple-drug combinations of antihypertensive medications, indicating a trend toward a more aggressive approach to hypertension management among Indian clinicians. The insights gleaned from this investigation can further assist healthcare professionals in crafting tailored treatment strategies for individuals grappling with hypertension. Such personalized approaches hold promise in enhancing treatment adherence and ultimately improving the QoL.

Abstract P304: A Prescription Trend Analysis of Antihypertensive Pharmacotherapy across Different Specialties in India

Objective: To evaluate the temporal trends in the prescription patterns of antihypertensive medications among healthcare practitioners in India. Methods: The prescription audit data utilized in this study, sourced from IQVIA, originated from a panel comprising 6000 clinicians practicing within the private sector. These prescriptions encompassed various classes of antihypertensive drugs, namely beta-blockers (BB), calcium channel blockers (CCB), angiotensin receptor blockers (ARB), angiotensin-converting enzyme (ACE) inhibitors, and diuretics. The analysis spanned the period from 2014 to 2022. The study also included an examination of combinations involving two or three medications from these drug classes. Results: Cardiologists' prescription rates for antihypertensive medications stood at 21% in 2017 and decreased to 19% by 2023. In 2023, the highest rate of prescribing antihypertensive drugs was observed among consultant physicians, with a rate of 30%, followed by general practitioners at 27%. Among anti-hypertensive medications, the prescription rates for BBs were highest (32%), followed by ARBs &amp; CCBs (25% &amp; 24% respectively); which remained almost constant throughout the study period. Single-drug formulation of antihypertensive medications was the most preferred (60%) among Indian clinicians. Prescription shares of fixed-dose combinations (FDC) of two antihypertensive drugs showed a slight decline (36% in 2017 to 34% in 2023) &amp; FDCs of triple-drug exhibited an upward trend (3% in 2017 to 5% in 2023). Among the two drug FDCs, ARB &amp; diuretics were most preferred (25% prescription share) &amp; triple drug FDCs, CCB, ARB &amp; diuretics were most preferred (76% prescription share). Conclusions: Antihypertensive drugs are the most commonly prescribed medication in the cardiology segment. Consultant physicians and general practitioners manage the majority of hypertension cases. Notably, there has been an observed rise in the preference for triple-drug combinations of antihypertensive medications, indicating a trend toward a more aggressive approach to hypertension management among Indian clinicians. The insights gleaned from this investigation can further assist healthcare professionals in crafting tailored treatment strategies for individuals grappling with hypertension. Such personalized approaches hold promise in enhancing treatment adherence and ultimately improving the quality of life for patients.

Survey of Insurance Pharmacists in Ise, Toba, and Shima Districts, Mie Prefecture, on the Recognition of Target Values for Diabetes Blood Glucose Control in the Elderly and the Status of Prescription Auditing

Survey of Insurance Pharmacists in Ise, Toba, and Shima Districts, Mie Prefecture, on the Recognition of Target Values for Diabetes Blood Glucose Control in the Elderly and the Status of Prescription Auditing

Use of Oral and Emergency Contraceptives After the US Supreme Court’s Dobbs Decision

The US Supreme Court Dobbs v Jackson Women's Health Organization decision allowed states to strengthen restrictions on abortion access, triggering the closure of family planning clinics and leading to confusion about the legality of emergency contraceptives (ECs). To evaluate the association between the Dobbs decision and fills for oral and emergency contraceptives in states that enacted the most restrictive abortion policies after Dobbs. This cohort study used data on contraceptive fills for women of reproductive age (15-49 years) in the US from IQVIA's National Prescription Audit PayerTrak and data from the Guttmacher Institute were used to categorize changes in abortion restrictions in each state. A difference-in-differences analysis compared changes in monthly fill rates for daily oral contraceptive pills (OCPs) and ECs in states that became most restrictive (implemented a full abortion ban after Dobbs) and comparison states (kept a medium level of abortion restrictions after Dobbs) before (March 2021 to November 2021) and after (July 2022 to October 2023) the Dobbs decision. State-level abortion restrictions. Monthly fills of OCPs and ECs per 100 000 women of reproductive age. Between March 2021 and October 2023, 142.8 million prescriptions for OCPs and 904 269 prescriptions for ECs were dispensed at US retail pharmacies. Before Dobbs, trends in monthly fill rates were similar for OCPs and ECs between the most restrictive and comparison states. After the Dobbs decision, states that became the most restrictive experienced an additional 4.1% decline in OCP fills with 285.9 fewer fills per 100 000 (95% CI, -495.8 to -6.8; P = .04). In contrast to OCPs, fills for ECs increased during the first year after Dobbs (July 2022 to June 2023) in both groups of states. However, 1 year after Dobbs (July 2023 to October 2023), the most restrictive states experienced an additional 65% decrease in emergency contraceptive fills with 13.2 fewer fills per 100 000 (95% CI, -27.2 to -4.1; P = .01). In this cohort study of prescriptions filled at US pharmacies, the Dobbs decision was associated with declines in oral contraceptives, particularly ECs, in states enacting the most restrictive abortion policies. Given the important role of OCPs and ECs in preventing pregnancy and the need for abortion, efforts to improve access may be needed, especially in states where legal abortion is no longer an option.