Table 1 Primary and secondary indicators applied to Pharmaceutical Benefits Scheme (PBS) dispensing claims data to measure each low-value prescribing practice
Low-value practice | Indicator | ||
|---|---|---|---|
Primary | Secondary | Secondary indicator justification | |
Don’t use benzodiazepines in the elderly | People ≥65 years with prevalent benzodiazepine use | People ≥65 years with incident (new) benzodiazepine use | New benzodiazepine use defines a narrower population of recipients of this practice than prevalent use |
Avoid antipsychotics for dementia | People ≥65 years dispensed an anti-dementia medicine in the same year or the three calendar years prior to being dispensed an antipsychotica | People ≥65 years with incident (new) antipsychotic use | Incident antipsychotic use is unlikely to be for an indication where the evidence of risk and benefit is clear (schizophrenia or bipolar disorder) |
Don’t routinely prescribe two or more antipsychotics concurrently | People ≥18 years dispensed two or more antipsychotics with overlapping treatment exposures of 60 days | As for primary but excluding long acting depot preparationsb | Concomitant use of a long acting depot with an oral antipsychotic may be necessary during initial stages of therapy while dosing is being optimized |