Data Impact Challenge Question 4

Question 4: Does pharmacist access to a patient’s dispensed medication history at the time of dispensing affect the rate of inappropriate prescriptions for opioid analgesics and benzodiazepines?

Rationale
A 2012 article by Dormuth et al. in British Columbia found that “The implementation of a centralized prescription network was associated with a dramatic reduction in inappropriate, filled prescriptions for opioids and benzodiazepines.” With such networks of medication information now available and in use across many provinces and territories (see Infoway 2013/14 annual report), more evidence is required to assess the impact on inappropriate prescriptions in other provinces and territories. The full article, including the specifics of the algorithm to identify a potentially inappropriate prescription having been filled, can be found here.

Guiding Specifications

The analysis will provide the following potentially inappropriate prescription rate (numerator/denominator below) for both pre- and post-go-live of a provincial or territorial drug information system (centralized prescription network).

Required metrics
Numerator:
 Total prescriptions deemed inappropriate applying the inappropriate prescription algorithm described by Dormuth et al.
Denominator: 
Total prescriptions with denominator as per Dormuth et al.
Sample: 
Minimum sample size of 100,000 prescriptions in denominator
Timeframe: 
Analysis should include at least one year of data prior to the deployment year of the provincial/territorial drug information system (centralized prescription network) and at least one year following the deployment year. Deployment years for fully deployed known systems include: Manitoba (1994), Alberta (2008), Saskatchewan (2008), PEI (2008).