The potentially inappropriate prescription of new drug: thiazolidinediones for patients with type II diabetes in Taiwan

Authors

  • Yu-Wen Wen,

    1. Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Tao-Yuan, Taiwan
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  • Yi-Wen Tsai,

    Corresponding author
    1. Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
    2. Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
    • Institute of Health and Welfare Policy, National Yang-Ming University, No. 155. Sec. 2, Linong St., Beitou District, Taipei 112, Taiwan.
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  • Weng-Foung Huang,

    1. Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
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  • Fei-Yuan Hsiao,

    1. Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
    2. Pharmaceutical Health Services Research Department, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
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  • Pei-Fen Chen

    1. Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan
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Abstract

Purpose

To examine the potentially inappropriate prescription of thiazolidinediones (TZD).

Methods

Data on TZD prescriptions were collected from Taiwan's National Health Insurance dataset from 2001 to 2006. TZDs were considered inappropriately prescribed when they were prescribed to patients who were (1) under 18 years old, (2) pregnant, who had (3) type 1 diabetes, (4) severe heart failure, (5) hepatic insufficiency, or (6) renal insufficiency and taking TZD + metformin in combination. We aggregated potentially inappropriate prescriptions of TZD for each health-care institution in each month starting from March 2001, when TZD was introduced to Taiwan's market.

Results

The potentially inappropriate prescription of TZD increased from 9.41% in 2001 to 12.50% in 2006. Prior inappropriate prescription led to a 0.06% (95%CI: 0.04–0.08) further increase in its later inappropriate prescription. Accumulated months of experience prescribing TZD was found associated with higher proportion of inappropriate prescription of TZD (0.03%, 95%CI: 0.01–0.05). However, it was negatively associated with new incidence of inappropriate prescription of TZD (−0.20, 95%CI: −0.22 to −0.18). The greater the volume of prior TZD prescription (−0.87%, 95%CI: −0.93 to −0.81) and the greater the number of accumulated months since adoption (−0.14%, 95%CI: −0.16 to −0.12), the greater the decrease in rates of new inappropriate prescriptions.

Conclusions

Along with the quick penetration of the new DM drug came an increased possibility that it would be prescribed inappropriately, a trend that persisted over time. Copyright © 2010 John Wiley & Sons, Ltd.

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