McBride J E, Pater J L, Dorland J L, Lam Y M
Kingston General Hospital, Ontario, Canada.
Ann Pharmacother. 1997 Apr;31(4):411-6. doi: 10.1177/106002809703100404.
To determine the extent of omeprazole prescribing in the senior population of Ontario over a 1-year period; the variation in omeprazole prescribing for this population according to age group, gender, and geographic region: and the extent of inappropriate prescribing of omeprazole for this population.
Retrospective drug utilization review of prescription drug insurance claims.
The Ontario Drug Benefit (ODB) program claims database.
The following outcomes were measured: the proportion of seniors in Ontario who received a prescription for omeprazole from April 1, 1992 to March 31, 1993: effects of age group, gender, and geographic region of residence on omeprazole prescribing; and the extent of inappropriate omeprazole prescribing according to the ODB criteria for use. Prescribing of omeprazole was defined as inappropriate if a first-line antiulcer drug (i.e., histamine2-receptor antagonist) was not prescribed within 1-6 months of the first prescription claim for omeprazole.
A total of 29,936 seniors in Ontario received omeprazole from April 1, 1992 to March 31, 1993 (2.53 recipients per 100 eligible population). The age-gender group most frequently prescribed omeprazole was women 65-74 years, followed by women and men 75 years or older, and then men 65-74 years. Omeprazole prescribing varied widely among the 48 provincial counties (range of 1.66 recipients per 100 eligible population to 4.52 recipients per 100 population, p < 0.001). There was no evidence of a clustering effect in omeprazole prescribing at the county level. Prescribing of omeprazole was considered to be inappropriate for 80.5% of recipients.
This study demonstrated the ineffectiveness of the ODB limited-use program in controlling omeprazole prescribing. Further study should be done to examine determinants of variation in prescribing by geographic region.
确定安大略省老年人群在一年时间内奥美拉唑的处方开具情况；根据年龄组、性别和地理区域，该人群奥美拉唑处方开具的差异；以及该人群中奥美拉唑不适当处方的情况。
对处方药保险理赔进行回顾性药物利用审查。
安大略省药品福利（ODB）计划理赔数据库。
测量以下结果：1992年4月1日至1993年3月31日期间安大略省接受奥美拉唑处方的老年人比例；年龄组、性别和居住地理区域对奥美拉唑处方开具的影响；以及根据ODB使用标准判断的奥美拉唑不适当处方情况。如果在首次开具奥美拉唑处方申请后的1 - 6个月内未开具一线抗溃疡药物（即组胺2受体拮抗剂），则将奥美拉唑的处方开具定义为不适当。
1992年4月1日至1993年3月31日期间，安大略省共有29,936名老年人接受了奥美拉唑治疗（每100名符合条件的人群中有2.53名接受者）。最常开具奥美拉唑的年龄 - 性别组是65 - 74岁的女性，其次是75岁及以上的女性和男性，然后是65 - 74岁的男性。在该省48个县中，奥美拉唑的处方开具差异很大（每100名符合条件的人群中接受者的范围为1.66名至每100名人群中4.52名，p < 0.001）。在县一级，没有证据表明奥美拉唑处方开具存在聚集效应。80.5%的接受者的奥美拉唑处方被认为是不适当的。
本研究表明ODB限量使用计划在控制奥美拉唑处方开具方面无效。应进一步研究以检查地理区域处方差异的决定因素。
