Impact of NPS MedicineWise General Practitioner education programs and Choosing Wisely Australia recommendations on prescribing of Proton Pump Inhibitors in Australia

Abstract

Background This study evaluated the impact of multifaceted NPS MedicineWise programs conducted in 2009 and 2015 that targeted general practitioners (GPs) to reduce unnecessary prescribing of proton pump inhibitors (PPIs). Methods Time series analyses of the dispensing rates of concessional PPI scripts between January 2006 and June 2016 using the Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) databases in Australia. Participants were GPs with dispensed PPI prescriptions to concessional patients between January 2006 and June 2016. The interventions were National NPS MedicineWise PPI educational programs in 2009 and 2015 delivered to all practising GPs in Australia. The 2015 intervention coincided with the release of Choosing Wisely Australia recommendations from the RACGP. Outcome measures included monthly dispensing rates of standard and low strength PPIs prescribed by GPs among concessional patients in Australia. Results Following the 2009 NPS MedicineWise program we observed a 6.7% reduction in the expected dispensing rate of standard strength PPIs among concessional patients between January 2006 and March 2015, and a total 8.6% reduction by June 2016 following the launch of the 2015 program. We observed a significant increase of 5.6% in the expected dispensing rate of low strength PPIs among concessional patients between April 2009 and March 2015, and no significant change in trend following the 2015 program. Conclusions The NPS MedicineWise programs were associated with reductions in the dispensing rate of standard strength PPIs, and with an increase in the dispensing rate of low-strength PPIs by June 2016. Although the rate of high-strength PPI prescribing is declining, these formulations still constitute the majority of PPI use in Australia. Regular interventions to sustain and improve PPI management by GPs may be warranted.