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Related Experiment Videos

Variability in abciximab (ReoPro) prescribing: evidence based or budget driven?

J E F Zwart-van Rijkom1, H G M Leufkens, M L Simoons

  • 1Department of Pharmacoepidemiology & Pharmacotherapy, Utrecht University, PO Box 80082, 3508 TB Utrecht, The Netherlands. J.E.F.Zwart-vanRijkom@pharm.uu.nl

Pharmacoepidemiology and Drug Safety
|May 10, 2002
PubMed
Summary

Prescribing of abciximab after percutaneous transluminal coronary intervention (PTCA) varied widely. Budget and prior clinical trial involvement predicted usage levels, highlighting the need for consistent patient selection criteria.

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Area of Science:

  • Cardiology
  • Health Economics
  • Clinical Pharmacy

Background:

  • Abciximab is a crucial medication for improving outcomes in patients undergoing percutaneous transluminal coronary intervention (PTCA).
  • Clinicians report budget constraints affecting the administration of abciximab to all eligible patients.
  • Understanding prescribing patterns is essential for optimizing resource allocation and patient care.

Purpose of the Study:

  • To investigate the prescribing patterns of abciximab in Dutch PTCA centers.
  • To identify factors influencing the level of abciximab usage.
  • To explore variations in patient selection criteria and their correlation with prescribing rates.

Main Methods:

  • A survey and interview-based study involving opinion leaders from all 13 Dutch PTCA centers.

Related Experiment Videos

  • Linear regression analysis was used to determine the relationship between abciximab prescribing levels and various factors.
  • Investigated determinants included PTCA volume, selection criteria, funding, financial restrictions, past clinical trial participation, stenting rates, and desired prescribing levels.

    • Main Results:

    • Abciximab prescribing rates varied significantly, ranging from 2% to 36% of all PTCAs across centers.
    • Patient selection criteria for abciximab differed substantially between institutions.
    • Center budget, investigatorship, size, and type were highly predictive of prescribing levels (R² = 0.93, p < 0.001).
    • Higher past participation in clinical trials correlated with increased abciximab prescribing.

    Conclusions:

    • Wide variations in abciximab prescribing patterns were observed shortly after its introduction.
    • Lack of consensus on patient selection criteria for abciximab treatment was evident.
    • Institutional budget and prior involvement in clinical trials emerged as key predictors of prescribing intensity.