title: [The efficiency of drug prescription: impact of a therapeutic exchange program].
abstract: OBJECTIVE
  To assess the impact of substituting proton pump inhibitors (PPI) for omeprazole.
  
  
  METHODS
  We performed a community trial of the impact of a therapeutic exchange program in the primary care teams of a region compared with non-implementation in a control region. The study included patients prescribed a PPI between May 2008 and June 2009. The intervention consisted of providing educational sessions to physicians (n=68), as well as a list of patients receiving a PPI who were suitable for therapeutic exchange. Information was gathered from medical records (PPI prescribed, primary care team) and the pharmacy database (cost of defined daily doses of the PPI). The percentage of therapeutic exchange in each region before and after the intervention was compared through relative risk (RR). The percentage of omeprazole at the end of each study period and changes in PPI costs were also calculated.
  
  
  RESULTS
  Therapeutic exchange was higher in the intervention group (RR: 4.2; 95%CI: 3.1-5.8) than in the control group (RR: 1.8; 95%CI: 1.2-2.6). The percentage of patients prescribed omeprazole increased from 86.2% to 89.3% in the intervention region and from 84.3% to 84.7% in the control region. The total cost of the PPI group decreased by 7.6% in the intervention region and increased by 2.0% in the control group.
  
  
  CONCLUSIONS
  This study demonstrates the effectiveness of the therapeutic exchange program. This is a simple intervention that is able to modify prescription and reduce its costs.
authors: Servicio de Atención Primaria Alt Penedès-Garraf, Insituto Catalán de la Salud, Vilanova i la Geltrú, Barcelona, España. irosich.cp.ics@gencat.cat
authors: Isabel
authors: I
authors: Rosich
authors: Alejandro
authors: A
authors: Allepuz
authors: Glòria
authors: G
authors: Alba
authors: Núria
authors: N
authors: Benages
authors: Teresa
authors: T
authors: Arranz
mesh_terms: D057915:Drug Substitution / Q000592:standards*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D015397:Program Evaluation; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*
chemical_list: D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors; D009853:Omeprazole