[Perceptions of GPs and community pharmacists on hypnotic prescribing on private prescriptions].
OBJECTIVE
Zolpidem and zopiclone ("Z-drugs") and benzodiazepine hypnotics are reimbursed by the statutory health insurance for short-term use and in exceptional cases for longer periods. A large proportion is prescribed on private prescriptions. The aim of this study was to assess the perceptions of general practitioners (GPs) and community pharmacists (CPs) on private prescriptions of hypnotics regarding frequency, reasons and measures for reduction.


METHODS
A questionnaire was mailed to a random sample of 1,350 GPs and 600 CPs in 2012.  Questions were partly identical. Due to multiple testing, only p-values ≤ 0.01 were considered statistically significant.


RESULTS
458 GPs and 202 CPs returned questionnaires (response 33.9 % and 33.7 %). According to the CPs, the proportions of private prescriptions was higher for Z-drugs than for benzodiazepines (57.5 vs. 47.4 %; p < 0.0001). The proportion of private prescriptions of Z-drugs was higher in the eastern than in the western part of Germany (78.2 vs. 52.3 %; p < 0.0001). For benzodiazepines no such differences were found. As most relevant reasons for private prescriptions, the specifications of the Arzneimittel-Richtlinie and patients' demands were named. Patients with long-term use receive more often private prescriptions.


CONCLUSIONS
A switch to private prescriptions for patients with long-term use seems conflicting, because such patients with (iatrogenic) dependence are indicated exceptional cases. Practicable changes of the regulatory framework are needed, their benefits and harms should be evaluated.
Abteilung Gesundheitsökonomie, Gesundheitspolitik und Versorgungsforschung, Zentrum für Sozialpolitik (ZeS), Universität Bremen.
F
F
Hoffmann
Abteilung Versorgungsforschung, Institut für Public Health und Pflegeforschung (IPP), Universität Bremen.
G
G
Schmiemann
Abteilung Gesundheitsökonomie, Gesundheitspolitik und Versorgungsforschung, Zentrum für Sozialpolitik (ZeS), Universität Bremen.
R
R
Windt
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D053961:Azabicyclo Compounds / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D003625:Data Collection; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D058005:General Practitioners / Q000523:psychology*; D005858:Germany; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007348:Insurance, Health / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D007356:Insurance, Pharmaceutical Services / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D008134:Long-Term Care / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D010595:Pharmacists / Q000523:psychology*; D010879:Piperazines / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D011725:Pyridines / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D000077334:Zolpidem
D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; D011725:Pyridines; C515050:zopiclone; D001569:Benzodiazepines; D000077334:Zolpidem