Efectividad de una estrategia de intervención en el patrón de prescripción del biosimilar glargina en atención primaria / Effectiveness of an intervention strategy in the biosimilar glargine prescription pattern in primary care

Objetivos: Evaluar el impacto de una estrategia de intervención en el patrón de prescripción de la insulina glargina biosimilar (IGBio) respecto al compuesto de referencia y analizar la influencia del perfil del prescriptor y su repercusión económica. Diseño: Estudio cuasiexperimental de tipo antes/después, con un grupo control. Emplazamiento: Dos áreas de gestión sanitaria (AGS) de Sevilla: AGS Sur (área intervención) y AGS Osuna (área control). Participantes: La totalidad de los médicos de atención primaria de cada área: 220 y 100, respectivamente. Intervención: Se realizaron sesiones formativas, se envió un boletín farmacoterapéutico e informes de retroalimentación mensual durante los 6meses tras la intervención formativa. El estudio fue llevado a cabo desde la comercialización del biosimilar, en octubre de 2015, hasta febrero de 2016 (pre-intervención) y desde febrero hasta agosto de 2016 (intervención). Mediciones principales: Los indicadores analizados han sido porcentaje de pacientes y porcentaje de dosis diaria definida (DDD) con IGBio respecto al total y el coste. Los médicos han sido analizados por subgrupos de edad, sexo, formación, tipo de contrato, años de experiencia y cupo. Resultados principales: Ambos indicadores aumentan al mismo nivel en ambas áreas antes de la intervención. Sin embargo, después de la intervención fueron significativamente diferentes entre las áreas (p < 0,0005), intervalo de confianza al 95% (2,5-4,7). La razón del porcentaje de incremento relativo acumulado de ambas variables entre áreas fue 3,73 veces mayor tras la intervención. En el área intervención no se encontraron diferencias para los subgrupos de médicos evaluados. Conclusiones: Estrategias encaminadas a la formación/información, así como el seguimiento a los profesionales sanitarios, inciden en el patrón de prescripción y pueden tener una repercusión económica. Nuestros resultados no se han visto influenciados por el perfil del prescriptor

Objectives: To examine the effects of specific interventions on biosimilar glargine insulin (BGI) prescribing in general practices and to analyse the influence of prescriber and economic impact. Design: Non randomized controlled study. Setting: General practices in 2 health areas of Seville, intervention and control group. Participants: 220 general practices (intervention group) and 100 general practices (control group). Intervention: Intervention group received educational seminars on biosimilar drugs, pharmacotherapeutic bulletin and prescribing feedback. The study was carried out from the biosimilar commercialization, October-2015, to February-2016 (pre-intervention) and from February to August 2016 (intervention). Main measurements: Percentage of patients and DDD with BGI respect to total glargine before and during intervention for both areas were analysed. Physicians have been analysed by subgroups of age, sex, training, type of contract, years of experience and quota. Main results: Both indicators for intervention group were significantly greater than for control group (P < .0005), with a 95% confidence interval (2.5-4.7). The ratio of the percentage of cumulative increase of both variables between areas was 3.73 times higher after the intervention. No differences were found for the evaluated categories of physicians in the intervention group. Conclusions: Intervention strategies aimed at training and information, as well as monitoring health professionals, influence the pattern of prescription and can have an economic impact. Our results have not been influenced by the profile of the prescriber

[Effectiveness of an intervention strategy in the biosimilar glargine prescription pattern in primary care]. / Efectividad de una estrategia de intervención en el patrón de prescripción del biosimilar glargina en atención primaria.

OBJECTIVES: To examine the effects of specific interventions on biosimilar glargine insulin (BGI) prescribing in general practices and to analyse the influence of prescriber and economic impact. DESIGN: Non randomized controlled study. SETTING: General practices in 2 health areas of Seville, intervention and control group. PARTICIPANTS: 220 general practices (intervention group) and 100 general practices (control group). INTERVENTION: Intervention group received educational seminars on biosimilar drugs, pharmacotherapeutic bulletin and prescribing feedback. The study was carried out from the biosimilar commercialization, October-2015, to February-2016 (pre-intervention) and from February to August 2016 (intervention). MAIN MEASUREMENTS: Percentage of patients and DDD with BGI respect to total glargine before and during intervention for both areas were analysed. Physicians have been analysed by subgroups of age, sex, training, type of contract, years of experience and quota. MAIN RESULTS: Both indicators for intervention group were significantly greater than for control group (P<.0005), with a 95% confidence interval (2.5-4.7). The ratio of the percentage of cumulative increase of both variables between areas was 3.73 times higher after the intervention. No differences were found for the evaluated categories of physicians in the intervention group. CONCLUSIONS: Intervention strategies aimed at training and information, as well as monitoring health professionals, influence the pattern of prescription and can have an economic impact. Our results have not been influenced by the profile of the prescriber.