Regional Influences on the Dispensing of Glucose Test Strips in Dutch Community Pharmacies

Abstract

Background: Pharmacy practice guidelines promote the role of community pharmacies in selfmonitoring of blood glucose. However, variations between Dutch pharmacies exist in the proportion of patients to whom test strips are dispensed. Objective: To assess whether variations between community pharmacies in dispensing of blood glucose test strips can be explained by differences in patient characteristics and the region in which the pharmacy is located. Setting: PHARMO-Record Linkage System containing drug dispensing histories from 40 community pharmacies of about 450,000 patients in the Netherlands. Method: We performed a retrospective cohort study. Data on prescription of all drugs and medical aids between 1991 and 2001 were extracted for all new users of antidiabetic drugs. Patients were excluded if the dispensing history did not allow classification of the type of diabetes or if the dispensing pharmacy could not be determined. The data were analysed using a Cox proportional hazard model. Main outcome measure: Time to first test strips dispensed. Results: We identified 8,233 starters of antidiabetic drugs. During a median follow-up of 2.1 years, 20% of the patients were dispensed test strips at least once. Community pharmacy was significantly associated with the dispensing of test strips after adjustment for patient characteristics. This association was less apparent when stratified for the geographical location of the pharmacy. Conclusion: Community pharmacy is an independent determinant of the start of use of test strips. Differences in dispensing of test strips between pharmacies are dependent on geographical region. This suggests that implementing practice guidelines for diabetes care in community pharmacy requires different approaches in different regions.

Correlating pharmaceutical data with a national health survey as a proxy for estimating rural population health

“…In other studies, the differences between treatment patterns [57], prescribing practices, and dispensing practices [58] have all been noted in state-level studies [59]. Finally, this methodology begs further exploration and refinement.…”

Fylkesvise forskjeller i salg av blodglukosestrimler og antidiabetika

“…Det har manglet studier som omhandler omfanget og bruken av egenmåling av blodglukosenivå hos denne pasientgruppen, både nasjonalt og internasjonalt. En studie fra Nederland fant signifikante geografiske forskjeller i tiden det tar fra en person begynner med legemidler for sin diabetes til de får utlevert strimler (17). Vi har tidligere publisert en studie hvor vi observerte en nasjonal forekomst av egenmåling på ca.…”

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“…The availability of these equipments have made it possible for many community pharmacists to use them in Point of Care Testing (POCT) to monitor patient's cholesterol level, blood glucose level, thyroid stimulating hormone (TSH) level, blood pressure and anticoagulant therapy 6,[10][11][12][13][14] . The ready availability of these POCT kits affords community pharmacists the opportunity to perform on-site laboratory services for patients 9 .…”