Effect of triplicate prescription policy on benzodiazepine administration in nursing home residents.
OBJECTIVE
To estimate the effect of a triplicate prescription policy on administration of benzodiazepines and possible substitute drugs in nursing home residents during 1994-1995.


METHODS
Retrospective cross-sectional study


METHODS
Medicare- and Medicaid-certified nursing homes in five states: New York, which has a policy requiring triplicate prescription forms for certain drugs, and four states without such a policy.


METHODS
A total of 211,177 nursing home residents.


RESULTS
Data were collected using the Minimum Data Set; logistic regression provided an estimated effect of the policy on prescribing benzodiazepines. We also estimated possible substitute drugs for benzodiazepines (e.g., barbiturates, antidepressants, antipsychotics, and miscellaneous sedative-hypnotics) while adjusting simultaneously for potential confounders. New York nursing home residents were less likely to be receiving benzodiazepine therapy than those in nonpolicy states (odds ratio 0.42; 95% confidence interval 0.41-0.44). No increases occurred in administration of benzodiazepine substitute drugs in New York versus states without a triplicate prescription policy.


CONCLUSIONS
Policy did affect prescription and administration of benzodiazepines in nursing homes in states with versus without a triplicate prescription policy Lack of substitution with other drugs makes it unclear whether overprescribing occurred in states without a policy, or undertreatment occurred in the state with a policy.
VanHaaren
A M
AM
School of Pharmacy, University of Rhode Island, Kingston, USA.
Lapane
K L
KL
Hughes
C M
CM
D000339:Affect / Q000187:drug effects; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001569:Benzodiazepines; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009518:New York; D009735:Nursing Homes / Q000592:standards*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011640:Public Policy; D012189:Retrospective Studies; D014481:United States
D014151:Anti-Anxiety Agents; D011619:Psychotropic Drugs; D001569:Benzodiazepines