Prescribed medication and nutrition of social care patients in Crete, Greece

Antibiotic prescriptions in primary health care in a rural population in Crete, Greece

Background

Antibiotic over-prescribing has generally been considered to be common in Greece, however not much is known about current antibiotic use.

Findings

The aim of this study was to investigate antibiotic prescribing in a well-defined rural population of 159 adults and 99 children over a 12-month period in Crete, Greece. The daily-defined doses (DDD) for 1000 people/day (DID) were 22.1 and 24.2 for children and adults respectively. The overall DID was 23.4, markedly lower than that previously reported for Greece. The use of penicillins was 49.5% of DDD in children and 31.7% in adults. Quinolones represented 2.2% of the total antibiotics (0% in children). Prescriptions of antibiotics were more common during the 3-month period from January to March for both children and adults.

Conclusions

The findings of this study confirm the seasonal distribution of antibiotics used and the predominance of prescribing for respiratory tract infections. In the area of the study, antibiotic use seems to be lower than that previously reported for Greece, probably as a result of the recently established net of well-trained primary health physicians.

Potential drug-drug interactions in prescriptions dispensed in community pharmacies in Greece

OBJECTIVES

To evaluate the nature, type and prevalence of potential drug-drug interactions (DDIs) in prescriptions dispensed in community pharmacies in Thessaloniki, Greece. Secondary objectives included the classification of DDIs as per pharmacotherapeutic class of the medications and the investigation of the relationship between medical specialties and the frequency of potential DDIs, as well as the relationship between DDIs and prescription size. Setting DDIs are a common cause of adverse drug reactions (ADRs) among patients using multiple drug therapy. In Greece a reliable computerized surveillance system for monitoring potential DDIs is not yet fully established. As a result, the prevalence of such DDIs in prescriptions dispensed by community pharmacies in Greece is unknown.

METHODS

We conducted a prospective, descriptive study. Over a 3-month period (November 2007-January 2008), a total of 1,553 handwritten prescriptions were collected from three community pharmacies in Thessaloniki, Greece. The prescriptions were processed using the Drug Interactions Checker within the www.drugs.com database. The identified potential DDIs were categorized into two classes, major and moderate, according to their level of clinical significance.

MAIN OUTCOME MEASURES

Overall 213 prescriptions had one or more potential DDIs and a total of 287 major and moderate DDIs were identified. Potential DDIs were identified in 18.5% of all prescriptions. Major DDIs were identified in 1.9% of all prescriptions and represented 10.5% of all DDIs detected, whereas moderate DDIs were identified in 16.6% of all prescriptions and represented 89.5% of all DDIs detected. The rate of DDIs increased with prescription size. The most common drug involved in major DDIs was amiodarone which interacts with potassium-wasting diuretics, digoxin, simvastatin and acenocoumarol.

CONCLUSIONS

Our results indicate that patients in Greece are at risk of ADRs caused by medications due to potential DDIs. An appropriate surveillance system for monitoring such interactions should be implemented and physicians should be more aware of potentially harmful DDIs. Pharmacists can contribute to the detection and prevention of drug-related injuries, especially of clinically meaningful DDIs that pose a potential risk to patient safety.

Drug utilization and health behaviours among indigent elderly patients in Crete, Greece

AIM

To examine pharmaceutical needs, prescribed drugs, knowledge about pharmacotherapy and health behaviours among Social Care indigent elderly patients.

PATIENTS

There were a total of 551 Social Care indigent patients registers in Chania, Crete, Greece at the time of the study (1995-97), of whom 89 (40 men and 49 women) were elderly patients (> or =65 years old). The control group comprised 171 (81 men and 90 women) Social Security insured elderly patients (> or =65 years old).

RESULTS

The socio-demographic profile of the indigent elderly patients reveals an unemployment rate of 99% (versus 5% in the control group, P<0.05) and an illiteracy rate of 38% (versus 5%, P<0.05). The most commonly prescribed defined daily doses (DDD) of medications were cardiovascular drugs (45.0% indigent versus 48.3%) and nervous system drugs (14.4% versus 8.8%). The most frequently prescribed drug, as a percentage of DDD, was nitroglycerin (14.5% versus 26.0%) and the most expensive drug, expressed as a percentage of the total cost of drugs, was omeprazole (6.5% versus 4.6%). The most common disease was hypertension (42.1% versus 23.2%, P<0.05). There were also significant differences between the two groups of patients (P<0.05) in the understanding of drug usage instructions (35.4% versus 68.6%), in asking the pharmacist for advice (44.6% versus 71.5%) and in understanding special diet instructions (18.7% versus 34.7%). Regarding the health behavior patterns, significant differences (P<0.05) were found in the consumption of sausages (38.6% versus 15.6%), salt (29.8% versus 12.0%), more than one glass per day of alcoholic drinks (13.8% versus 4.3%) and in daily smoking cigarettes (48.8% indigent versus 12.8% control).

CONCLUSION

The present study emphasizes the need for more information on drug use and the necessity for a continuing health educational intervention among Social Care indigent elderly patients.