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Published in: Drugs & Therapy Perspectives 2/2024

24-02-2024 | Diclofenac | Original Research Article

Evaluation of diclofenac utilization patterns before and after digital risk minimization intervention in outpatient settings in Montenegro

Authors: Maja Stankovic, Nemanja Turkovic, Silva Dobric, Nemanja Rancic

Published in: Drugs & Therapy Perspectives | Issue 2/2024

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Abstract

Introduction

Risk minimization measures are one of the most important tools in ensuring safe use of medicines. The evaluation of their effectiveness in clinical practice is a big challenge. Diclofenac is a medicine indicated for relief of all grades of pain and inflammation, in a wide range of conditions. Certain cardiovascular diseases are contraindications, whilst certain diseases require precautions for diclofenac prescribing.

Objective

The aim of this study is to measure impact of the new digital risk minimization tool, introduced at the level of diclofenac prescribing, on patterns of its prescription in outpatient settings in Montenegro.

Methods

Regulatory impact before/after drug utilization study, using electronic health records of patients with cardiovascular contraindications/precautions for diclofenac prescribing, was conducted. The period of observation was 1 year before and 1 year after introduction of the digital risk minimization tool.

Results

Introduction of the digital risk minimization tool was associated with significant decrease in number of patients on diclofenac and the number of diclofenac prescriptions/packages, in a cohort of patients who were prescribed diclofenac before the digital intervention. Decrease in diclofenac prescription was more obvious in patients with contraindications, as expected, compared with patients with precautions. Decrease in diclofenac prescriptions in patients with other heart diseases, cerebrovascular diseases, and ischemic heart diseases (contraindications) was 38.79%, 37.62%, and 29.85% respectively. There was also a decrease in diclofenac prescriptions in patients with hypertension (22.86%), hyperlipidemia (23.61%), and diabetes mellitus (26.32%; precautions). After the digital intervention, initiation of diclofenac in diclofenac-naive patients was significantly decreased compared with patients who were prescribed diclofenac before the digital intervention.

Conclusions

Although a significant decrease in diclofenac prescription in both cohorts occurred, diclofenac is still prescribed, even in diagnoses contraindicated for its use. Further improvements of existing tools and the creation of new ones are necessary for minimization of cardiovascular and other risks related to diclofenac.
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Metadata
Title
Evaluation of diclofenac utilization patterns before and after digital risk minimization intervention in outpatient settings in Montenegro
Authors
Maja Stankovic
Nemanja Turkovic
Silva Dobric
Nemanja Rancic
Publication date
24-02-2024
Publisher
Springer International Publishing
Keyword
Diclofenac
Published in
Drugs & Therapy Perspectives / Issue 2/2024
Print ISSN: 1172-0360
Electronic ISSN: 1179-1977
DOI
https://doi.org/10.1007/s40267-024-01049-w

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