1.Therapeutic Duplication as a Medication Error Risk in Fixed-Dose Combination Drugs for Dyslipidemia: A Nationwide Study
Wonbin CHOI ; Hyunji KOO ; Kyeong Hye JEONG ; Eunyoung KIM ; Seung-Hun YOU ; Min-Taek LEE ; Sun-Young JUNG
Korean Journal of Clinical Pharmacy 2023;33(3):168-177
		                        		
		                        			 Background:
		                        			& Objectives: Fixed-dose combinations (FDCs) offer advantages in adherence and cost-effectiveness compared to free combinations (FCs), but they can also complicate the prescribing process, potentially leading to therapeutic duplication (TD). This study aimed to identify the prescribing patterns of FDCs for dyslipidemia and investigate their associated risk of TD.  
		                        		
		                        			Methods:
		                        			This was  a  retrospective cohort  study  involving  drugs  that  included  statins, using  Health  Insurance  Review  & Assessment ServiceNational Patient Sample (HIRA-NPS) data from 2018. The unit of analysis was a prescription claim. The primary outcome was TD.The risk ratio of TD was calculated and adjusted for patient, prescriber, and the number of cardiovascular drugs prescribed using a multivariable Poisson model.  
		                        		
		                        			Results:
		                        			Our study included 252,797 FDC prescriptions and 515,666 FC prescriptions. Of the FDC group, 46.52% were male patients and 56.21% were aged 41 to 65. Ezetimibe was included in 71.61% of the FDC group, but only 0.25% of the FC group. TD occurred in 0.18% of the FDC group, and the adjusted risk ratio of TD in FDC prescriptions compared to FC  was  6. 44  (95%  CI  5. 30-7. 82).    
		                        		
		                        			Conclusions
		                        			 Prescribing  FDCs  for  dyslipidemia  was  associated  with  a  higher  risk  of  TD compared  to  free  combinations.  Despite  the  relatively  low  absolute  prevalence  of  TD,  the  findings  underline  the  necessity  for strategies to mitigate this risk when prescribing FDCs for dyslipidemia. Our study suggests the potential utility of Clinical Decision Support Systems and standardizing nomenclature in reducing medication errors, providing valuable insights for clinical practice and future research. 
		                        		
		                        		
		                        		
		                        	
            
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