Adherence to prescribing recommendations made on a provincial formulary

Area of Science:

• Health Services Research
• Pharmacoeconomics
• Geriatric Medicine

Background:

• The Ontario Drug Benefit Formulary provides
• therapeutic notes
• guidance on appropriate and cost-effective prescription drug use.

Purpose of the Study:

• To assess adherence to therapeutic note recommendations for new aliskiren and sitagliptin prescriptions among Ontario seniors.
• To evaluate the frequency of non-conformance with established drug prescribing guidelines.

Main Methods:

• A cross-sectional study was conducted on Ontario residents aged 66 and older.
• Prescription data for aliskiren and sitagliptin between December 1, 2008, and March 31, 2012, were analyzed.
• Prescribing patterns were compared against Ontario Drug Benefit Formulary therapeutic note recommendations.

Main Results:

• Approximately half of initial aliskiren prescriptions (51.4%) did not conform to therapeutic note guidance.
• Similarly, 49.3% of initial sitagliptin prescriptions deviated from recommended prescribing practices.
• A high rate of non-conformance was observed for both studied medications.

Conclusions:

• Current therapeutic note guidance for aliskiren and sitagliptin shows suboptimal adherence among prescribers for elderly patients.
• Policymakers should consider alternative interventions to improve prescriber behavior, enhancing healthcare quality and efficiency.
• The findings highlight a gap between guideline recommendations and actual prescribing practices in geriatric pharmacotherapy.