BackgroundThe Pharmaceutical Benefits Scheme (PBS) is Australia’s national drug subsidy program. This paper provides a practical guide to researchers using PBS data to examine prescribed medicine use.FindingsExcerpts of the PBS data collection are available in a variety of formats. We describe the core components of four publicly available extracts (the Australian Statistics on Medicines, PBS statistics online, section 85 extract, under co-payment extract). We also detail common analytical challenges and key issues regarding the interpretation of utilisation using the PBS collection and its various extracts.ConclusionsResearch using routinely collected data is increasing internationally. PBS data are a valuable resource for Australian pharmacoepidemiological and pharmaceutical policy research. A detailed knowledge of the PBS, the nuances of data capture, and the extracts available for research purposes are necessary to ensure robust methodology, interpretation, and translation of study findings into policy and practice.

Background Prescription drug misuse is a growing public health concern globally. Routinely collected data provides a valuable tool for quantifying prescription drug misuse.Objective To synthesize the global literature investigating prescription drug misuse utilizing routinely collected, person-level prescription/dispensing data to examine reported measures, documented extent of misuse and associated factors.Methods We searched MEDLINE, Embase, CINAHL, MEDLINE In Process, Scopus citations and Google Scholar for relevant articles published between January 1 2000-July 31 2013. We screened 10,803 abstracts and retrieved 281 full-text manuscripts. Fifty-two peer-reviewed, English-language manuscripts met our inclusion criteria: an aim/method investigating prescription drug misuse and a measure of misuse derived exclusively from prescription/dispensing data.Results Four proxies of prescription drug misuse were used commonly across studies: number of prescribers, dispensing pharmacies, early refills and volume of drugs dispensed. We identified 89 unique measures of misuse across the 52 studies, reflecting the heterogeneity in how measures are constructed; single or composite; different thresholds, cohort definitions and time period of assessment. Consequently, it was not possible to make definitive comparisons about the extent (range reported: 0.01-93.5%), variations and factors associated with prescription drug misuse.Conclusion Routine data collections are relatively consistent across jurisdictions. Despite the heterogeneity of the current literature, our review identifies the capacity to develop universally accepted metrics of misuse applied to a core set of variables in prescription/dispensing claims. Our timely recommendations have the potential to unify the global research field and increase the capacity for routine surveillance of prescription drug misuse. 3 Key points Prescription drug misuse is increasing globally. This can be monitored readily using routinely collected data; quantifying drug access patterns at the population-level. Our review identified only four common proxies for prescription drug misuse (number of prescribers; number of dispensing pharmacies; volume of drug(s) dispensed; and/or overlapping prescriptions/early refills) yet they were used to derive 89 unique definitions of misuse due to variations in thresholds, or use alone or in combination. We recommend the development of consistent and replicable metrics to facilitate monitoring and comparisons of the extent of prescription drug misuse across health care settings and over time.

No abstract