Prescribing of dosulepin in Wales remained high compared with North-east England (similar demographically to Wales). NPIs have been developed by the All Wales Medicines Strategy Group (AWMSG) to promote safe, cost-effective prescribing in specific key therapeutic areas since 2004. GP practices in Wales are encouraged to move towards the NPI threshold as part of a prescribing incentive scheme. Monitoring of dosulepin primary care prescribing was introduced
as an NPI in Wales in April 2011. The aim of this study was to examine the impact of this advice on dosulepin prescribing in Wales. Primary care dosulepin usage data from December 2006 to December 2012
were obtained using the Comparative Analysis System for Prescribing Audit (CASPA) version selleck screening library 1.0.4.7 (NHS Wales Shared Services Partnership [NWSSP]) accessed online February 2013. This software provides a record of all dispensed WP10 prescriptions forwarded to Prescribing Services, NWSSP for processing and payment. Defined daily doses (DDDs)/1,000 prescribing units (PUs) was used to monitor usage. Linear regression analysis was used to assess changes in prescribing over time. Data were analysed using GraphPad Prism version 5 (GraphPad Software, California, USA). Ethical approval was not required. From December 2006 to December 2007, the rate of dosulepin use in Wales decreased by 0.21 DDDs/1,000 PUs per month. From December 2007 until NADPH-cytochrome-c2 reductase September 2009, the rate of use decreased by buy Ganetespib 0.33 DDDs/1,000 PUs per month. This increase in the rate of change compared to the previous period was not significant (p = 0.47, linear regression analysis). In the following 18 months (October 2009 to March 2011), use decreased at the rate of 0.47 DDDs/1,000 PUs – a non-significant change over the previous period (p = 0.25, linear regression
analysis). Following the introduction of the NPI in April 2011 until December 2012, usage reduced at the rate of 0.80 DDDs/1,000 PUs per month, a significant change compared with the previous period (p < 0.01, linear regression analysis). In the 12 months to December 2007, the rate of dosulepin use in Wales remained constant. Following the publication of MHRA guidance in December 2007, there was a reduction in the rate of use, although not statistically significant. Similarly, the reduction in the rate of use did not change significantly following the introduction of NICE CG90 in 2009. However, in the period from April 2011 to December 2012, following introduction of the NPI, there was a significant increase in the rate of reduction in use compared to the previous period.