Prescribing pattern in a Dutch university hospital

In many countries, including The Netherlands, little is known about the overall prescribing patterns within hospitals. While individual hospitals have some data available, these are not pooled on a regional or national level. The available data consist of dispensing data that are neither patient-linked nor diagnosis-linked. We report the results of a study in a Dutch university hospital which show that despite the limitations, such data can be used for a general evaluation of prescribing patterns. Using three categories of undesirable or irrational drug prescribing the dispensing data were screened. The categories were 'inferior or dubious' drugs, 'semi-innovative' drugs, and 'inappropriately used' drugs. The results show that most problems are seen with the use of new drugs. In the first instance, this involves the use of semi-innovative drugs whose adoption may be stimulated by clinical trials in the hospital concerned. Secondly, innovative drugs seem to be used on too large a scale, i.e., for indications for which their use is not warranted. Based on these findings, a follow-up study has been initiated to study some of these suboptimal drug choices in detail.