Sunday, February 04, 2007

A Mix of Troublesome and Overblown

The Tennessean is reporting today that "Tennesseans lead nation in prescriptions," stating that, "Tennesseans use more prescription drugs than any other state in the nation — an average of 17.3 prescriptions for every man, woman and child, according to a new study by BlueCross BlueShield of Tennessee. The state's prescription drug spending topped $7 billion in 2005, according to the insurer's latest report. The national average is 11.3 prescriptions per person." If Tennesseans are receiving too many, unnecessary prescriptions, that's a problem.

However, the article states, "That figure includes everything from people who take dozens of pills per day to people who take a single prescription but refill it every month and are recorded as taking 12 prescriptions that year." That's the part that makes no sense. If what the Tennessean reports is true, every woman in the state who refills birth control every month would be counted as taking 12 prescriptions, when they are only taking one drug on a regular basis. It is also unclear whether this includes only prescriptions that an individual goes to a pharmacy to fill, or whether it would include every drug administered during a hospitalization, and how many of the prescriptions are chronic, or everyday pills, as opposed, for example, to antibiotics for a short-term illness. The Tennessean piece lists several "chronic" drugs for chronic conditions among the list, so I wonder if those are contributing to overcounting the number of drugs people are truly taking.

Tennessee certainly has problems in healthcare management. "Tennessee ranks 47th nationwide in the health of its residents. It has some of the nation's highest rates of drug-resistant infections and accidental drug overdoses...'We are over-prescribing. That much is clear," said Dr. William Schaffner, an epidemiologist and chairman of preventive medicine at the Vanderbilt University School of Medicine. 'It's not that the doctors in all the other 49 states are getting it wrong and we're on the right track. ... It's a matter that has puzzled us for some time.'" Maybe the doctors and hospitals and health administrators are getting more detailed data that answers some of these questions about counting. If not, then I suspect we'll continue to be puzzled, because the Tennessean's report doesn't include enough information on the findings and methodology to make any valid observations about the state of prescription-writing in the State. Not having a clear representation of the true picture is bound to hinder progress in making the necessary corrections.

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MeSH Tags: Prescriptions, Drug; Tennessee


Blogger Kat Coble said...

I commented on this over at NiT, but wanted to comment here, too, since this is such a huge button-presser for me. (ha! lucky you....)

I wrote about this awhile back. The false statistic angers me, because all of my prescriptions for a chronic health condition, which must be RE-PRESCRIBED (not just refilled) every month count as twelve prescriptions instead of one. It makes it sound as though I take 36 prescriptions a year and am overprescribed when in fact I take three prescriptions a year and am quite underprescribed in comparison to other folks who share my condition.

'We are over-prescribing. That much is clear," said Dr. William Schaffner, an epidemiologist and chairman of preventive medicine at the Vanderbilt University School of Medicine.

Hah. I call bullsh!t. I get that he's an epidemiologist, but from where I sit, I've been told by several out-of-state specialists who consult on my condition that I am undertreated and badly managed for my condition. I've also been told that some of that is a reactionary position to the 'Tennessee prescribes too much' myth.

The physician quoted is an epidemiologist. Given that is his speciality he may have an educated opinion about the overprescription of antibiotics. (That would directly affect epidemiology.) But there are other drugs out there--urological, gynocological, cardiac, CNS, pain management--you name it. I don't know that the epidimiologist is qualified to speak to the prescriptive necessity of other medications.

I also think it's crazy that the Tennessean is essentially running a story from April of last year. Way to be on top of it, Tennessean.

6:37 PM  

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