Substantial variation in prescribing practices seen by locality of practice
THURSDAY, April 19, 2018 (HealthDay News) — Recent policy changes have led to a decline in the prescribing of gluten-free foods in England, according to research published online April 16 in BMJ Open.
Alex J. Walker, Ph.D., from the University of Oxford in the United Kingdom, and colleagues describe time trends, variation, and factors associated with prescribing gluten-free foods in England.
The researchers found that between July 2016 and June 2017 there were 1.3 million gluten-free prescriptions, a decline from 1.8 million in 2012 to 2013. This decline reduced costs by £6.7 million. Substantial variation in prescribing rates among practices was seen, ranging from 0 to 148 prescriptions per 1,000 patients. This variation was in part driven by prescribing policy differences at the Clinical Commissioning Group level. Lower prescribing rates were seen for practices in the most deprived quintile versus those in the highest quintile (incidence rate ratio, 0.89), which may reflect lower rates of celiac disease diagnosis in more deprived populations.
“Prescribing of gluten-free foods is declining rapidly and given recent policy changes seems likely to continue to do so,” the authors write. “The variation in prescribing between different practices and in different areas of the country seems to be largely determined by the decisions and preferences of clinicians and local health services.”
One author disclosed financial ties to the pharmaceutical industry.
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