Off-Record Prescription of Hypnotics
Analyse aus hausärztlichen Routinedatengerman translation / full article
Analysis from Family Physicians’ Electronic Health Records
Background: Because health services research in Germany is lacking representative and longitudinal data, the assumption that hypnotics are delivered in Statutory Health Insurance (SHI) to patients via out-of-pocket prescription cannot be properly examined. Our aim was to ascertain if primary data from family physicians’ electronic record systems can be used to study out-of-pocket prescriptions of hypnotics to SHI members.
Methods: We studied retrospectively a sample of 3.5 million single drug prescriptions to more than 200,000 members of Statutory Health Insurance, 1993 to 2006, gained via the BDT software interface from 147 family physicians’ electronic health record system. After finding data entities appropriate for identification of insurance, ATC code, and kind of prescription, we calculated relative risks (RR) from observed frequencies.
Results: For SHI members we found a RR of 1.22 (95 % confidence interval 1.17–1.27) to receive an out-of-pocket prescription for benzodiazepines or Z-drugs, compared to same kind of prescription for any other medication. 0.4 % of all prescriptions to SHI patients cover these substances.
Conclusions: Family practices´ electronic record data can be used to identify and analyze off-record prescription of hypnotics to SHI members. We advocate the implementation of a scientific software interface into practice information systems to obtain routine data from ambulatory care for secondary scientific purposes. This approach guarantees numerous repetitions, transparency, reproduction and data privacy protection with minimum disturbance to practices’ every day function.