SwapINN: Analytic Study about Prescription Swaps at Pharmacies

Detalhes bibliográficos
Autor(a) principal: Moutinho, Ana
Data de Publicação: 2014
Outros Autores: Alexandra, Denise, Rodrigues, Renata
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4278
Resumo: Introduction: In order to cut spending, compulsory INN prescription was suggested in Portugal during 2012. This instigated discussion among stakeholders in the matter. The authors studied prescription-dispensing dynamics in a real population.Objectives: To determine the percentage of swapped prescriptions; to assess factors associated with the swap; to analyse justifications for doing so; to quantify the cost difference for patients and the National Health Service.Material and Methods: Analytic study. Convenience sample consisting of all prescriptions from a Primary Health Care unit, from the 19th to the 23rd December 2011. Third day follow-up, using phone call interviews. Software: Excel and SPSS. Tests: Chi-square and Mann-Whitney, SL = 0.05.Results: Total of 255 prescriptions. Majority prescribed to women (62%), mean age of 52, four years of school education and for acute situations. A percentage of 31% of prescribed drugs were swapped. The swaps had no statistical relation with age, sex or literacy of the patient, nor with the prescriber or pharmacy. Swapping of prescribed drugs for chronic situations was lower (p < 0.001), as well as for original brand prescriptions (p < 0.001). Anti-infectious and anti-allergic were the most swapped groups (p = 0.009). Seventy-two percent of users were not aware of the swap. Regarding the swapped drugs, users paid on average 79% more than what was originally prescribed, and the National Health Service 5% more.Discussion/Conclusion: The authors found changes in 31% of the prescriptions, with higher costs for both users and National Health Service. Selection, information and registration bias were considered. With compulsory INN prescriptions, we suggest regular analysis of prescription-dispensing dynamics, based on the available national data.
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spelling SwapINN: Analytic Study about Prescription Swaps at PharmaciesDCIsão: Estudo Analítico sobre a Substituição de Prescrições nas FarmáciasIntroduction: In order to cut spending, compulsory INN prescription was suggested in Portugal during 2012. This instigated discussion among stakeholders in the matter. The authors studied prescription-dispensing dynamics in a real population.Objectives: To determine the percentage of swapped prescriptions; to assess factors associated with the swap; to analyse justifications for doing so; to quantify the cost difference for patients and the National Health Service.Material and Methods: Analytic study. Convenience sample consisting of all prescriptions from a Primary Health Care unit, from the 19th to the 23rd December 2011. Third day follow-up, using phone call interviews. Software: Excel and SPSS. Tests: Chi-square and Mann-Whitney, SL = 0.05.Results: Total of 255 prescriptions. Majority prescribed to women (62%), mean age of 52, four years of school education and for acute situations. A percentage of 31% of prescribed drugs were swapped. The swaps had no statistical relation with age, sex or literacy of the patient, nor with the prescriber or pharmacy. Swapping of prescribed drugs for chronic situations was lower (p < 0.001), as well as for original brand prescriptions (p < 0.001). Anti-infectious and anti-allergic were the most swapped groups (p = 0.009). Seventy-two percent of users were not aware of the swap. Regarding the swapped drugs, users paid on average 79% more than what was originally prescribed, and the National Health Service 5% more.Discussion/Conclusion: The authors found changes in 31% of the prescriptions, with higher costs for both users and National Health Service. Selection, information and registration bias were considered. With compulsory INN prescriptions, we suggest regular analysis of prescription-dispensing dynamics, based on the available national data.Introdução: A prescrição obrigatória por DCI foi imposta em 2012, para redução de custos do SNS e motivou discussão entre as partes envolvidas. Estudámos, numa população real, a dinâmica prescrição-dispensa de medicamentos.Objetivos: Determinar a percentagem de prescrições substituídas; avaliar os fatores associados à substituição; identificar as respetivas justificações; quantificar os diferenciais dos custos para utente e Serviço Nacional de Saúde.Material e Métodos: Estudo analítico. Amostra de conveniência constituída pelos medicamentos prescritos de uma unidade de saúde, de 19 a 23 de Dezembro de 2011. Três dias depois, os utentes foram entrevistados telefonicamente. Software: Excel® e SPSS®. Testes: Qui-quadrado e Mann-Whitney; n.s. = 0,05.Resultados: Total de 255 prescrições. A maioria foi efetuada a mulheres (62%), idade média 52 anos, 4 anos de escolaridade (33%) e para situações agudas (53%). Foram substituídas 31% das prescrições, sem relação com idade, sexo ou escolaridade, nem com o médico prescritor ou farmácia. Os medicamentos prescritos para situações crónicas foram menos substituídos (p < 0,001), assim como as prescrições de marca (p < 0,001). Os anti-infeciosos e anti-alérgicos foram os grupos com mais substituições (p = 0,009). Os utentes não se aperceberam da substituição em 72% dos casos. Nos casos de substituição, o utente pagou, em média, mais 79% que o prescrito e o Serviço Nacional de Saúde 5%.Discussão/Conclusão: Verificou-se substituição de 31% das prescrições, com mais custos para utente e Serviço Nacional de Saúde. Consideramos possível viés de seleção, informação e registo. Sendo agora obrigatória a prescrição por DCI, sugerimos a análise regular, a nível nacional, com base nas aplicações informáticas em uso, da prescrição e respetiva dispensa.Ordem dos Médicos2014-01-08info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4278oai:ojs.www.actamedicaportuguesa.com:article/4278Acta Médica Portuguesa; Vol. 27 No. 1 (2014): January-February; 92-98Acta Médica Portuguesa; Vol. 27 N.º 1 (2014): Janeiro-Fevereiro; 92-981646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4278https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4278/3882https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4278/3964Moutinho, AnaAlexandra, DeniseRodrigues, Renatainfo:eu-repo/semantics/openAccess2022-12-20T11:03:32Zoai:ojs.www.actamedicaportuguesa.com:article/4278Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:18:46.975404Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv SwapINN: Analytic Study about Prescription Swaps at Pharmacies
DCIsão: Estudo Analítico sobre a Substituição de Prescrições nas Farmácias
title SwapINN: Analytic Study about Prescription Swaps at Pharmacies
spellingShingle SwapINN: Analytic Study about Prescription Swaps at Pharmacies
Moutinho, Ana
title_short SwapINN: Analytic Study about Prescription Swaps at Pharmacies
title_full SwapINN: Analytic Study about Prescription Swaps at Pharmacies
title_fullStr SwapINN: Analytic Study about Prescription Swaps at Pharmacies
title_full_unstemmed SwapINN: Analytic Study about Prescription Swaps at Pharmacies
title_sort SwapINN: Analytic Study about Prescription Swaps at Pharmacies
author Moutinho, Ana
author_facet Moutinho, Ana
Alexandra, Denise
Rodrigues, Renata
author_role author
author2 Alexandra, Denise
Rodrigues, Renata
author2_role author
author
dc.contributor.author.fl_str_mv Moutinho, Ana
Alexandra, Denise
Rodrigues, Renata
description Introduction: In order to cut spending, compulsory INN prescription was suggested in Portugal during 2012. This instigated discussion among stakeholders in the matter. The authors studied prescription-dispensing dynamics in a real population.Objectives: To determine the percentage of swapped prescriptions; to assess factors associated with the swap; to analyse justifications for doing so; to quantify the cost difference for patients and the National Health Service.Material and Methods: Analytic study. Convenience sample consisting of all prescriptions from a Primary Health Care unit, from the 19th to the 23rd December 2011. Third day follow-up, using phone call interviews. Software: Excel and SPSS. Tests: Chi-square and Mann-Whitney, SL = 0.05.Results: Total of 255 prescriptions. Majority prescribed to women (62%), mean age of 52, four years of school education and for acute situations. A percentage of 31% of prescribed drugs were swapped. The swaps had no statistical relation with age, sex or literacy of the patient, nor with the prescriber or pharmacy. Swapping of prescribed drugs for chronic situations was lower (p < 0.001), as well as for original brand prescriptions (p < 0.001). Anti-infectious and anti-allergic were the most swapped groups (p = 0.009). Seventy-two percent of users were not aware of the swap. Regarding the swapped drugs, users paid on average 79% more than what was originally prescribed, and the National Health Service 5% more.Discussion/Conclusion: The authors found changes in 31% of the prescriptions, with higher costs for both users and National Health Service. Selection, information and registration bias were considered. With compulsory INN prescriptions, we suggest regular analysis of prescription-dispensing dynamics, based on the available national data.
publishDate 2014
dc.date.none.fl_str_mv 2014-01-08
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publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 27 No. 1 (2014): January-February; 92-98
Acta Médica Portuguesa; Vol. 27 N.º 1 (2014): Janeiro-Fevereiro; 92-98
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0870-399X
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