title: Adherence to prescribing recommendations made on a provincial formulary.
abstract: Guidance regarding appropriate and cost-effective use of prescription drugs is published in the Ontario Drug Benefit Formulary in the form of "therapeutic notes." We conducted a cross-sectional study of all residents of Ontario aged 66 and older who received a new prescription for one of two drugs, aliskiren or sitagliptin, between December 1, 2008 and March 31, 2012 to determine how frequently such guidance is followed. Approximately half of initial prescriptions for aliskiren and sitagliptin were prescribed in a manner that did not conform to the therapeutic note recommendations (51.4% and 49.3%, respectively). Given this high rate of non-conformance, policy makers may wish to use other mechanisms to influence prescriber behaviour to improve the quality and efficiency of healthcare.
authors: Division of Nephrology, Western University London, ON.
authors: Ainslie M
authors: AM
authors: Hildebrand
authors: Institute for Clinical Evaluative Sciences Toronto, ON.
authors: Zhan
authors: Z
authors: Yao
authors: Institute for Clinical Evaluative Sciences Li Ka Shing Knowledge Institute, St. Michael's Hospital Toronto, ON.
authors: Tara
authors: T
authors: Gomes
authors: Institute for Clinical Evaluative Sciences Toronto, ON.
authors: Ximena
authors: X
authors: Camacho
authors: Division of Nephrology & Department of Epidemiology and Biostatistics, Western University, London, ON Institute for Clinical Evaluative Sciences, Toronto, ON.
authors: Amit X
authors: AX
authors: Garg
authors: Institute for Clinical Evaluative Sciences Department of Medicine, University of Toronto Toronto, ON.
authors: David N
authors: DN
authors: Juurlink
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D005650:Fumarates / Q000627:therapeutic use; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D009864:Ontario / Q000453:epidemiology; D010602:Pharmacopoeias as Topic / Q000592:standards*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011719:Pyrazines / Q000627:therapeutic use; D000068900:Sitagliptin Phosphate; D014230:Triazoles / Q000627:therapeutic use
chemical_list: D000577:Amides; D000959:Antihypertensive Agents; D005650:Fumarates; D007004:Hypoglycemic Agents; D011719:Pyrazines; D014230:Triazoles; C446481:aliskiren; D000068900:Sitagliptin Phosphate