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Related Experiment Videos

Selective prescribing of spasmolytics.

K L Movig1, A C Egberts, A W Lenderink

  • 1Hospital Pharmacy Midden-Brabant, TweeSteden Hospital, Tilburg, The Netherlands. KMovig@zamb.tsz.nl

The Annals of Pharmacotherapy
|June 22, 2000
PubMed
Summary

Tolterodine is prescribed to a different patient group than older spasmolytic drugs, often as a later-line treatment with more concomitant medications. This selective prescribing impacts real-world drug outcome assessments.

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Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Real-world Evidence

Background:

  • Clinical trial settings often differ from daily practice, potentially leading to biased assessments of drug safety, effectiveness, and economic outcomes.
  • Prescriber selection of patients for new drugs can introduce bias when evaluating real-world outcomes.

Purpose of the Study:

  • To compare the patient profiles receiving tolterodine versus previously marketed spasmolytic drugs (oxybutynin, flavoxate, emepronium).

Main Methods:

  • An observational, follow-up study conducted in eighteen community pharmacies.
  • Included noninstitutionalized patients aged 18 years or older receiving initial therapy with tolterodine, oxybutynin, flavoxate, or emepronium.

Main Results:

Related Experiment Videos

  • Tolterodine was frequently used as a second- or third-line treatment.
  • Patients receiving tolterodine showed higher likelihoods of prior spasmolytic use (RR 7.5) and concomitant use of antiparkinsonian (RR 4.1) and antipsychotic drugs (RR 2.9).
  • Concomitant use of antidepressants and benzodiazepines showed minimal differences.

    • Conclusions:

    • Tolterodine is prescribed to a distinct patient population compared to older spasmolytic agents.
    • Selective prescribing practices necessitate consideration when evaluating new drugs in real-world clinical settings.
    • Formulary decision-makers should account for selective prescribing to avoid biased conclusions on drug efficacy, safety, and cost-effectiveness.