Objectives The criteria for the reimbursement of fluoroquinolones changed in Belgium on 1 May 2018. This study aims to quantify the difference in fluoroquinolone use after this change, and to assess the timing and persistence of this effect, both in terms of total reimbursed fluoroquinolone use and its relative proportion. Methods Longitudinal reimbursement data on fluoroquinolone use in the Belgian community from January 2017 to November 2018 were analysed to identify a change in reimbursed fluoroquinolone use expressed in DDD per 1000 inhabitants per day (DID), using a set of non-linear mixed models including change-points. In addition, longitudinal data on the relative proportion of prescribed fluoroquinolones from January 2017 to December 2018 were analysed to identify a change in the relative proportion of prescribed fluoroquinolones using generalized estimation equations including change-points. Results Fluoroquinolone use dropped significantly immediately after the change in reimbursement criteria, from 2.21 DID (95% CI: 2.03–2.38) to 0.52 DID (95% CI: 0.48–0.56) and from 9.14% (95% CI: 8.75%–9.56%) to 6.52% (95% CI: 6.04%–7.04%). The observed decrease in fluoroquinolone use persisted over time. Conclusions While fluoroquinolone use was still above the target of 5% after the change in reimbursement criteria, its implementation helped to lower fluoroquinolone use in Belgium.

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改变报销标准对比利时氟喹诺酮类药物使用的影响

目标 2018 年 5 月 1 日，比利时氟喹诺酮类药物的报销标准发生了变化。本研究旨在量化这一变化后氟喹诺酮类药物使用的差异，并评估这种影响的时间和持续性，包括报销的氟喹诺酮类药物使用总量和其相对比例。方法 使用一组非线性混合模型，分析 2017 年 1 月至 2018 年 11 月比利时社区氟喹诺酮类药物使用的纵向报销数据，以确定报销的氟喹诺酮类药物使用量的变化，以每 1000 名居民每天的 DDD (DID) 表示-点。此外，分析了 2017 年 1 月至 2018 年 12 月处方氟喹诺酮类药物相对比例的纵向数据，以使用包括变化点的广义估计方程确定处方氟喹诺酮类药物相对比例的变化。结果 报销标准改变后，氟喹诺酮类药物的使用立即显着下降，从 2.21 DID (95% CI: 2.03–2.38) 降至 0.52 DID (95% CI: 0.48–0.56) 和从 9.14% (95% CI: 8.75%–9.56) %) 至 6.52% (95% CI: 6.04%–7.04%)。随着时间的推移，观察到的氟喹诺酮使用减少持续存在。结论 虽然报销标准改变后氟喹诺酮类药物的使用率仍高于 5% 的目标，但其实施有助于降低比利时的氟喹诺酮类药物使用量。结果 报销标准改变后，氟喹诺酮类药物的使用立即显着下降，从 2.21 DID (95% CI: 2.03–2.38) 降至 0.52 DID (95% CI: 0.48–0.56) 和从 9.14% (95% CI: 8.75%–9.56) %) 至 6.52% (95% CI: 6.04%–7.04%)。随着时间的推移，观察到的氟喹诺酮使用减少持续存在。结论 虽然报销标准改变后氟喹诺酮类药物的使用率仍高于 5% 的目标，但其实施有助于降低比利时的氟喹诺酮类药物使用量。结果 报销标准改变后，氟喹诺酮类药物的使用立即显着下降，从 2.21 DID (95% CI: 2.03–2.38) 降至 0.52 DID (95% CI: 0.48–0.56) 和从 9.14% (95% CI: 8.75%–9.56) %) 至 6.52% (95% CI: 6.04%–7.04%)。随着时间的推移，观察到的氟喹诺酮使用减少持续存在。结论 虽然报销标准改变后氟喹诺酮类药物的使用率仍高于 5% 的目标，但其实施有助于降低比利时的氟喹诺酮类药物使用量。