Prescribing Trends for Oral Vancomycin and Fidaxomicin after Guideline and Formulary Changes in Ontario, Canada: An Interrupted Time-Series Analysis.

The Canadian journal of hospital pharmacy Pub Date : 2024-08-14 eCollection Date: 2024-01-01 DOI:10.4212/cjhp.3560
Mira Maximos, Colleen Maxwell, John-Michael Gamble
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Abstract

Background: Clostridioides difficile is a pathogen causing diarrheal illness, which can be treated with vancomycin or fidaxomicin.

Objective: To evaluate changes in monthly prescription volumes for oral vancomycin and fidaxomicin in Ontario community pharmacies following implementation of the 2017 and 2021 updates to guidelines from the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) and after a 2019 provincial formulary change for vancomycin.

Methods: An interrupted time-series analysis was conducted from November 2015 to October 2021 using monthly projected prescription volumes obtained from IQVIA's Compuscript database. Level and slope (trend) changes in prescribing were assessed using segmented linear regression.

Results: The volume of vancomycin prescriptions increased by 74 prescriptions per month (95% confidence interval [CI] 16 to 132) following implementation of the 2017 guideline update and by 73 prescriptions per month (95% CI 13 to 133) after the 2019 formulary change; however, no statistically significant changes were observed after implementation of the 2021 guideline update. No significant trend changes were observed for fidaxomicin.

Conclusion: Guidelines and formulary changes were correlated with increased volume of vancomycin prescriptions.

加拿大安大略省指南和处方变更后口服万古霉素和非达霉素的处方趋势:间断时间序列分析
背景:艰难梭菌是一种导致腹泻的病原体,可通过万古霉素或菲达霉素治疗:艰难梭菌是一种导致腹泻的病原体,可以用万古霉素或菲达霉素治疗:目的:评估安大略省社区药房在实施美国传染病学会(IDSA)和美国医疗流行病学学会(SHEA)2017 年和 2021 年指南更新以及 2019 年万古霉素省级处方变更后,口服万古霉素和非达霉素每月处方量的变化:利用从 IQVIA 的 Compuscript 数据库中获取的每月预测处方量,对 2015 年 11 月至 2021 年 10 月期间的处方量进行了间断时间序列分析。使用分段线性回归评估了处方量的水平和斜率(趋势)变化:结果:万古霉素处方量在 2017 年指南更新实施后每月增加 74 张(95% 置信区间 [CI] 16 至 132),在 2019 年处方变更后每月增加 73 张(95% 置信区间 [CI] 13 至 133);但在 2021 年指南更新实施后未观察到显著的统计学变化。非达霉素未观察到明显的趋势变化:结论:指南和处方集的变化与万古霉素处方量的增加有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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