AUTHOR=Russo Veronica , Orlando Valentina , Monetti Valeria Marina , Galimberti Federica , Casula Manuela , Olmastroni Elena , Tragni Elena , Menditto Enrica , EDU.RE.DRUG Group , Catapanoa Alberico L. , Tragni Elena , Menditto Enrica , Corrao Giovanni , Casula Manuela , Galimberti Federica , Olmastroni Elena , Russo Veronica , Orlando Valentina , Mucherino Sara , Scotti Lorenza , Zambon Antonella , Gambera Marco , Piccinelli Rossana , Sonzogni Samanta , Valsecchi Valter , Scopinaro Eugenio , Raineri Sandro , Speziali Alessia , Creazzola Simona , Tari Michele , Fusco Mariano TITLE=Geographical Variation in Medication Prescriptions: A Multiregional Drug-Utilization Study JOURNAL=Frontiers in Pharmacology VOLUME=11 YEAR=2020 URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2020.00418 DOI=10.3389/fphar.2020.00418 ISSN=1663-9812 ABSTRACT=Background

Studies have emphasized the importance of geographical factors and general practitioner (GP) characteristics in influencing drug prescriptions.

Objectives

To: (i) ascertain the prevalence rate (PR) of use of drugs in six therapeutic categories used for chronic conditions; (ii) assess how geographical characteristics and GP characteristics may influence drug prescribing.

Methods

This study is part of the EDU.RE.DRUG Project, a national collaborative project founded by Italian Medicine Agency (AIFA). Cross-sectional analyses were undertaken employing the pharmacy-claim databases of four local health units (LHUs) located in two Italian regions: Lombardy and Campania. Six drug categories were evaluated: proton-pump inhibitors; antibiotics; respiratory-system drugs; statins; agents acting on the renin−angiotensin system; psychoanaleptic drugs. The PR was estimated according to drug categories at the LHU level. A linear multivariate regression analysis was undertaken to evaluate the association between the PR and geographical area, age and sex of GPs, number of patients, and percentage of patients aged >65 per GP.

Results

LHUs in Campania showed a PR that was significantly higher than that in Lombardy. Antibiotics showed the highest PR in all the LHUs assessed, ranging from 32.5% in Lecco (Lombardy) to 59.7% in Naples-2 (Campania). Multivariate linear regression analysis confirmed the association of the PR with geographical area for all drug categories. Being located in Campania increased the possibility of receiving a drug prescription from the categories considered, with estimates more marked for antibiotics, proton-pump-inhibitors, and respiratory-system drugs.

Conclusions

This study provides information about the PR of medications used for treating common and costly conditions in Italy and highlighted a significant geographical variation. These insights could help to develop area-specific strategies to optimize prescribing behavior.