Effect of restrictions on prescribing patterns for dextropropoxyphene

Area of Science:

• Pharmacology
• Clinical Pharmacy
• Health Services Research

Background:

• Dextropropoxyphene compound analgesics were widely prescribed.
• Concerns existed regarding their efficacy and safety profile.
• Hospital formularies often restrict access to certain medications.

Purpose of the Study:

• To evaluate the impact of restricting dextropropoxyphene compound prescribing to consultants only.
• To assess changes in inpatient versus outpatient prescribing patterns.
• To understand the implications for the use of alternative analgesics.

Main Methods:

• Retrospective analysis of prescribing data within a teaching hospital.
• Comparison of prescribing trends before and after the implementation of prescribing restrictions.
• Examination of shifts in the use of paracetamol and other compound analgesics.

Main Results:

• Immediate and significant reduction in inpatient dextropropoxyphene compound prescriptions.
• Slower but substantial decrease in outpatient prescriptions, indicating continued utility.
• Increased use of paracetamol and other compound analgesics, notably those with high-dose codeine.
• Pharmacy audit methods were deemed insufficient for detailed analysis.

Conclusions:

• Prescribing restrictions on dextropropoxyphene compounds led to differential impacts on inpatient and outpatient settings.
• Patients and clinicians perceived ongoing value in dextropropoxyphene compounds, necessitating slower adoption of alternatives.
• The study highlights the need for careful monitoring of prescribing changes and potential unintended consequences of drug restrictions.