USE OF PHYSICIAN PROFILES TO INFLUENCE PRESCRIBING OF TOPICAL CORTICOSTEROIDS

Main Article Content

Ingrid S Sketris
George Kephart
Charmaine A Cooke A Cooke
Chris D Skedgel D Skedgel
Pam R McLean-Veysey

Keywords

Topical corticosteroids, physician prescribing profiles, drug utilization

Abstract

Background


Physician profiling is a tool used to attempt to affect changes in prescribing. The Drug Evaluation Alliance of Nova Scotia (DEANS) decided to implement a physician profiling project to determine if prescribing of topical corticosteroids could be altered.


 Objectives


To evaluate a DEANS initiative utilizing physician prescribing profiles to shift prescribing of topical corticosteroids from higher to lower potency agents in beneficiaries of the Nova Scotia Seniors’ Pharmacare Program.


 Methods


Administrative claims from the Nova Scotia Seniors’ Pharmacare program were used to identify prescriptions for topical corticosteroids. Prescriptions were summarized at the individual physician level, and aggregated by Anatomical Therapeutic Classification into weak, moderately potent, potent and very potent products. The number of prescriptions for topical corticosteroids was compared for the twelve- month period before and after mailing of the profiles. Overall results were aggregated by utilization and expenditures.


 Results


The number of prescriptions for topical corticosteroids per physician profiled was 44.0 in 2000/2001 and 42.8 in 2001/2002 (p=NS) and the expenditures per physician profiled were $838.94 in 2000/2001 and $826.81 in 2001/2002 (p=NS). There was a small decrease in prescriptions dispensed for potent topical products over the profiling period (52.4% of prescriptions in 2000/2001 versus 51.5% of prescriptions in 2001/2002, p=0.03). Otherwise, changes in utilization or expenditures for topical corticosteroids were not statistically different between the profiling periods.


 Conclusions


This project showed that mailing unsolicited individual-level profiles did not alter prescribing or expenditures for topical corticosteroids over a two-year period. Further work is needed to determine physician attitudes towards such projects.

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