Effectiveness of a Structured Intervention to Optimize the Use of Mirabegron

Overview

This study was a multicentre, quasi-experimental design, controlled, before-and-after trial to estimate the effectiveness related to the review of mirabegron use and, if appropriate, its discontinuation. Intervention group: Patients with mirabegron prescription assigned to any of the 17 primary health care centers (PHC) located in the northern area of Barcelona. Control group: All the other patients assigned to any of the other 34 health care centers in Barcelona belonging to the Catalan Institut of Health (CIH). The structured intervention included initiatives with general practitioners and urologists/gynaecologists, management support from health care authorities, and monthly feed-back monitoring to general practitioners (GPs). The follow-up period was 12 months, from January 1st to December 31st, 2017.

A quasi-experimental design with before/after measurement and a control group was used. The objective was to identify the effectiveness of a training activity on the review of treatments. In addition, it was proposed to establish the duration of medication in real clinical practice, and its prevalence of use before and after the intervention. Control group: Usual care Intervention: * Initiatives for healthcare professionals: information and training with written material, in an diagram format, distributed to all general practitioners. * Initiatives for specialized hospital care: information regarding the intervention for urologists and gynaecologists. * Management support with the definition of a structured strategy for all the addresses of the PHC and GPs. * Monthly monitoring of the intervention (feed-back to all GPs). The intervention consisted of: a) meetings with all the directors of the PHC; b) informative meetings and sessions in the PHC; c) distribution of the diagram to all the GPs; d) lists of patients with treatment provided periodically from the medication area; and e) review of the treatments by the GPs. If considered appropriate, and with the consent of the patient, the medication was withdrawn. A pharmacist and a clinical pharmacologist acted as consultants in case of any doubts regarding specific patients.