VanHaaren A M, Lapane K L, Hughes C M
School of Pharmacy, University of Rhode Island, Kingston, USA.
Pharmacotherapy. 2001 Oct;21(10):1159-66. doi: 10.1592/phco.21.15.1159.33898.
To estimate the effect of a triplicate prescription policy on administration of benzodiazepines and possible substitute drugs in nursing home residents during 1994-1995.
Retrospective cross-sectional study
Medicare- and Medicaid-certified nursing homes in five states: New York, which has a policy requiring triplicate prescription forms for certain drugs, and four states without such a policy.
A total of 211,177 nursing home residents.
Data were collected using the Minimum Data Set; logistic regression provided an estimated effect of the policy on prescribing benzodiazepines. We also estimated possible substitute drugs for benzodiazepines (e.g., barbiturates, antidepressants, antipsychotics, and miscellaneous sedative-hypnotics) while adjusting simultaneously for potential confounders. New York nursing home residents were less likely to be receiving benzodiazepine therapy than those in nonpolicy states (odds ratio 0.42; 95% confidence interval 0.41-0.44). No increases occurred in administration of benzodiazepine substitute drugs in New York versus states without a triplicate prescription policy.
Policy did affect prescription and administration of benzodiazepines in nursing homes in states with versus without a triplicate prescription policy Lack of substitution with other drugs makes it unclear whether overprescribing occurred in states without a policy, or undertreatment occurred in the state with a policy.
评估三联处方政策对1994 - 1995年期间疗养院居民使用苯二氮䓬类药物及可能的替代药物的影响。
回顾性横断面研究
五个州的医疗保险和医疗补助认证疗养院：纽约州有一项政策要求某些药物使用三联处方，另外四个州没有这样的政策。
总共211,177名疗养院居民。
使用最小数据集收集数据；逻辑回归分析得出该政策对开具苯二氮䓬类药物处方的估计影响。我们还估计了苯二氮䓬类药物的可能替代药物（如巴比妥类药物、抗抑郁药、抗精神病药和其他镇静催眠药），同时对潜在混杂因素进行了调整。与无该政策的州相比，纽约州疗养院居民接受苯二氮䓬类药物治疗的可能性较小（优势比0.42；95%置信区间0.41 - 0.44）。与无三联处方政策的州相比，纽约州苯二氮䓬类替代药物的使用没有增加。
有三联处方政策的州与无该政策的州相比，政策确实影响了疗养院中苯二氮䓬类药物的处方和使用情况。缺乏其他药物的替代使用使得不清楚在无政策的州是否存在过度开药的情况，或者在有政策的州是否存在治疗不足的情况。
