EDUCATIONAL-PROGRAM TO IMPROVE THE DOSAGE PRESCRIBING OF ALLOPURINOL

Objective: To perform and evaluate an educational intervention program aimed at improving the dosage prescribing of allopurinol by general practitioners and based on the application of academic detailing. Design, setting and participants: General practitioners in southern Tasmania were sent educational material about allopurinol, highlighting the need to adjust dosages in accordance with the renal function of the patient. Most general practitioners then discussed the rational prescribing of allopurinol directly with a visiting pharmacist. Main outcome measures: Pharmacoepidemiological data provided by a statewide database containing dispensing data from community pharmacies throughout Tasmania, and Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) data. The key variable was the percentage of prescriptions for allopurinol that were for the 100 mg form. Results: The program's success was indicated by a statistically significant increase in the prescribing of 100 mg allopurinol in the intervention region. The database showed an increase from 14.8% to 22.1% of all prescriptions for allopurinol (P<0.05), while PBS and RPBS data revealed an increase from 12.5% to 22.2% of all prescriptions for allopurinol dispensed under both schemes (P<0.0001). Conclusions: A program incorporating academic detailing can modify prescribing practices within the community. A statewide pharmacoepidemiological database provides a valuable means of evaluating interventions designed to improve prescribing.