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High Risk Prescribing in the Veteran Population
Author(s) -
Parkes A.
Publication year - 1995
Publication title -
australian journal on ageing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 34
eISSN - 1741-6612
pISSN - 0726-4240
DOI - 10.1111/j.1741-6612.1995.tb00710.x
Subject(s) - veterans affairs , medicine , pharmacist , drug , population , pharmacy , pharmaceutical benefits scheme , medication reconciliation , chemist , medical prescription , family medicine , medical emergency , pharmacology , environmental health , physics , quantum mechanics
Concerns about the frequency and consequences of adverse drug reactions have prompted the Department of Veterans' Affairs to establish a ‘quality use of medicines’ program. This involves several approaches, including patient and pharmacist education and prescriber pharmaceutical feedback. The traditional approach, regulatory change, is also used to influence prescribing. The process of prescribing feedback involves the identification of high risk prescribing situations, such as the prescribing of drug combinations known to interact significantly. Analysis of prescribing information for veterans indicates the extent to which these ‘high risk’ situations occur. Increased regulation for the prescribing of certain of the benzodiazepines on the Repatriation Pharmaceutical Benefits Scheme was introduced in April 1993. Analysis of drug utilisation, using the Department of Veterans' Affairs pharmaceutical database reveals, not surprisingly, that this has had a dramatic effect on the prescribing of the newly restricted drugs. The prescribing of all benzodiazepines including restricted and unrestricted drugs however, has dropped by a net of 11% when comparing twelve month periods before and after the introduction of restrictions. Equally importantly, the prescribing of tricyclic antidepressants (TCA) has not significantly changed implying that prescribers are not routinely changing from benzodiazepines to TCAs.