Impact of an intervention on the prescription of aliskiren after new evidence on safety reported. Issue 1 (16th November 2016) - Rosich Martí, Isabel
Abstract: Purpose: The purpose of the study is to analyze the impact of an intervention to disseminate safety alerts on the utilization of Aliskiren added to angiotensin converting enzyme inhibitor (ACEI) or an angiotensin‐receptor blocker (ARB). Methods: Quasi‐experimental design (non‐randomized intervention) comparing the utilization of Aliskiren + ACEI or ARB in a primary care area‐intervention (PCA‐I) with a primary care area‐control (PCA‐C) following a safety alert. All physicians were provided with a list of diabetic patients (DM) on Aliskiren + ACEI or ARB. Physicians in the PCA‐I received also a non‐DM patients list, a report with recommendations and information on the utilization of Aliskiren + ACEI or ARB in their area. Information was obtained from electronic medical records, period from May 2010 to December 2012. Interrupted time series analysis were used to assess the effect of the intervention on the number of patients on Aliskiren + ACEI or ARB. Results: The number of DM receiving Aliskiren + ACEI or ARB at the time of the alert (23 December 2011) was 106 in the PCA‐I (91 non‐DM) and 45 in the PCA‐C (25 non‐DM). After the alert, a decreased in the number of patients on Aliskiren + ACEI or ARB was noted at both PCAs, although the average of daily treatments ended was significantly higher in the PCA‐I, both in the DM group (slope after alert: −0.81, 95%CI −0.91 to −0.71 vs. −0.30, 95%CI −0.37 to −0.22) as well as in the non‐DM group (−0.56, 95%CI −0.67 to −0.45 vs. −0.10 95%CI −0.17 to −0.04). Conclusions: The prescription of Aliskiren + ACEI or ARB decreased at both PCAs, albeit such decreased was more significant at the PCA‐I. The intervention led to a more expeditious implementation of the safety alert recommendations. Copyright © 2016 John Wiley & Sons, Ltd.