Original scientific paper
Do regulatory guidelines for recommendation and prescription of medications affect off label treatment with atypical antipsychotics and anticonvulsants in Osijek-Baranja County?
Dražen Gorjanski
; Hrvatski zavod za zdravstveno osiguranje
Mario Ćurković
orcid.org/0000-0003-0101-0254
; University of Osijek School of Medicine
Abstract
Purpose: This paper explores the relationship between regulatory guidelines for recommen-dation and prescription of medications and off label treatment with atypical antipsychotics and anticonvulsants in Osijek-Baranja County.
Methods: 27,361 prescriptions for atypical antipsychotics and 3,265 prescriptions for anti-convulsants were obtained from the Croatian Health Insurance Fund’s electronic data base on the usage of atypical antipsychotics and anticonvulsants recommended by Osijek-Baranja County psychiatrists in 2015. For each patient, medical diagnosis was compared with the diagnoses in Agency for Medicinal Products and Medical Devices of Croatia. Prescriptions for which diagnosis did correspond with registered diagnoses were marked as on label, while prescriptions for which diagnosis did not correspond to registered diagnoses were marked off label.
Results: During 2015 in Osijek-Baranja County 1,086 (37.1%) of 2,928 patients treated with atypical antipsychotics were subjected to off label treatment; among which 1,085 (99.97%) patients were treated with disregard for legal regulations. Two hundred and twenty six (57.7%) of 392 patients treated with anticonvulsants were subjected to off label treatment; 226 (100%) of which were treated with disregard for legal regulations. All prescriptions for off label treatments were prescribed with disregard for legal regulations.
Conclusion: The frequency of off label treatment with atypical antipsychotics and anticonvulsants in Osijek-Baranja County is similar to that of countries in which off label prescribing is permitted. Psychiatrists and primary care physicians in Osijek-Baranja County disregard legal guidelines for recommending and prescribing medications when treating patients with atypical antipsychotics and anticonvulsants.
Keywords
regulation; guidelines; off label treatment; antipsychotics; anticonvulsants
Hrčak ID:
212638
URI
Publication date:
13.12.2018.
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