The Impact of International Nonproprietary Names Integration on Prescribing Reimbursement Medicines for Arterial Hypertension and Analysis of Medication Errors in Latvia

Abstract

The use of international nonproprietary names (INNs) has been mandatory for prescriptions of state-reimbursed drugs in Latvia since 1 April 2020. In a retrospective analysis, we aimed to examine the impact of the new regulation on changes in the prescribing and dispensing practice of antihypertensive agents with an example of bisoprolol or/and perindopril and their combinations. All state-reimbursed bisoprolol and/or perindopril prescriptions for arterial hypertension were evaluated in two time periods: 1 April 2018 to 31 March 2019 and 1 April 2020 to 31 March 2021. The proportion of INN prescriptions increased from 2.1% to 92.3% (p < 0.001, φ = 0.903). The rate of fixed-dose combinations (FDCs) increased from 60.8% to 66.5% (p < 0.001, φ = 0.059). The rate of medication errors was 0.6%. The most common (80.6%) error was that the dispensed medicine dose was larger or smaller than indicated on the prescription. In addition, prescribing an FDC medicine increased the chance of making an error by 2.5 times on average. Regulatory changes dramatically affected the medicine-prescribing habits of INNs. The increase in FDC prescription rates may align with the recommendations of the 2018 ESC/ESH guidelines. The proportion of total errors is estimated as low, but control mechanisms are needed to prevent them.

Role of a National Health Service Electronic Prescriptions Database in the Detection of Prescribing and Dispensing Issues and Adherence Evaluation of Direct Oral Anticoagulants

“…It has been proven that providing recommendations is insufficient to bring about substantial changes in behaviour or practices. Regulation changes are necessary [45]. This study's results also indicate a significant impact on practice by the mandatory use of electronic prescribing systems from 2018 and INN from 2020 for reimbursement purposes [46,47].…”

When I use a word . . . The languages of medicines—International Nonproprietary Names (INNs)

“…For example, they were adopted in Australia in 2016 7 and in Latvia in April 2020. 8 A before-and-after study in Latvia showed that after the adoption of INNs, their use in prescriptions for bisoprolol and/or perindopril increased from 2.1% to 92.3% and the rate of medication errors fell from 0.81% to 0.39%.…”