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Effect of federally mandated education policies on prescribing of isotretinoin to women of childbearing age
Author(s) -
Heckbert Susan R.,
Mtshali Glaudine,
Platt Richard
Publication year - 1993
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.2630020310
Subject(s) - medicine , isotretinoin , psychological intervention , family medicine , demography , nursing , dermatology , sociology , acne
We evaluated the effect of federally mandated educational interventions designed to reduce prenatal exposures to isotretinoin. We determined the number of isotretinoin courses prescribed at a health maintenance organization to women aged 15 through 44 between March 1987 and February 1990, and the number that had pre‐treatment pregnancy testing. The number of courses initiated without pre‐treatment testing fell by 54%, from 3.6 to 1.7 courses per month after educational programs were in place ( p < 0.01). This decrease was principally due to a decrease in prescribing from 1.1 to 0.6 courses per 1000 women‐years ( p < 0.002), although testing also increased from 51% (54 of 105) to 58% (21 of 36) of courses. These overall changes resulted from two distinct patterns of responses by physicians. Physicians who initially tested in over 40% of, courses (aggregate testing, 71% of courses (50 of 70)) reduced their collective prescribing from 5.0 to 0.3 courses per month and maintained a stable testing rate. In contrast, physicians who initially tested in fewer than 10% of courses increased their collective prescribing from 2.3 to 3.0 courses per month, and also increased testing from 6% (two of 32) to 56% (15 of 27) of courses.