The effect of an educational intervention on meperidine use in Nova Scotia, Canada: a time series analysis

Abstract

Purpose-To evaluate the impact of a prescriber focused individual educational and auditfeedback intervention undertaken by the Nova Scotia Prescription Monitoring Program (NSPMP) in March/April 2007 to reduce meperidine use.Method-The NSPMP records all prescriptions for controlled substances dispensed in community pharmacies in Nova Scotia, Canada. Oral meperidine use from 1 July 2005 to 31 December 2009 was examined using NSPMP data. Monthly totals for the following were obtained: number of individual patients who filled at least one meperidine prescription, number of prescriptions, and number of tablets dispensed. Data were analyzed graphically to observe overall trends. The intervention effect was estimated on the logarithmic scale with autocorrelations over time modeled by an integrated autoregressive moving average model for each outcome measure. Results-An CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript confidence interval [CI] = 5%-18%), prescriptions by 10% (p <0.001; 95%CI = 3%-17%), and tablets by 13.5% (p <0.001, 95%CI = 6%-29%) in the post-intervention period.Conclusion-Given the risks associated with meperidine, determining that this intervention successfully reduced meperidine use is encouraging. This study highlights the potential for using population data such as the NSPMP to evaluate the effectiveness of population-level interventions to improve medication use, including professional, organizational, financial, and regulatory initiatives.

Voluntary warnings and the limits of good prescribing behavior: the case for de-adoption of meperidine

“… 12 In 2007 in Nova Scotia, an effort was made to reduce meperidine use with audit and feedback techniques to educate the small number of prescribers who prescribed the highest amounts of meperidine. 11 This study made use of Nova Scotia Prescription Monitoring Data that records all prescriptions for controlled drugs filled in community pharmacies from 2005 to 2010. While a decline was already evident, there was some evidence that the decline of meperidine use was enhanced by this low-cost medication intervention.…”

“… 5 , 8 – 10 There has been relatively limited assessment of the issue of meperidine use in the less regulated community setting. 11 …”

Prescriber response to unsolicited prescription drug monitoring program reports in Massachusetts

“…Although evidence suggests unsolicited reports may result in safer prescribing, little information is available regarding how providers use such reports. This paper describes findings of a Massachusetts Department of Public Health survey of prescribers who received unsolicited reports on patients using multiple prescribers and pharmacies.…”

Meperidine (pethidine) versus morphine in acute pain management of opioid-dependent patients

“…Morphine is the standard opium-based analgesic with well-known analgesic effects and side effects 7. Meperidine (pethidine) is another opioid, but the use of meperidine is not very popular in countries such as the USA and Canada, however it is still used in Iran for pain management in the ED 7,8. In our country, Iran, the only opioids that can be parenterally used in the ED for acute pain management are meperidine, morphine, and fentanyl.…”