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Jensen HK, Rasmussen L, Furu K, Karlstad Ø, Linder M, Cesta CE, Pottegård A. Use of non-insulin antidiabetic drugs in children and young adults - A Scandinavian drug utilization study from 2010-2019. Br J Clin Pharmacol 2021; 87:4470-4475. [PMID: 33871080 DOI: 10.1111/bcp.14867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/04/2021] [Accepted: 04/06/2021] [Indexed: 12/12/2022] Open
Abstract
Knowledge on utilization patterns of non-insulin antidiabetic drugs in childhood and youth is limited. Therefore, we conducted a population-based drug utilization study using publicly available aggregate data on use of non-insulin antidiabetics from 2010 to 2019 in Scandinavia (Denmark, Norway and Sweden) in individuals aged up to 24 years. For each non-insulin antidiabetic drug, we calculated the annual prevalence proportion of users, overall and for specific age groups. From 2010 to 2019, the prevalence of non-insulin antidiabetic users in Scandinavia increased 37% from 0.43 to 0.59/1000 individuals. The prevalence proportions were highest among female adolescents and young adults, but the largest relative increase in use was seen among 10-14-year-olds (78%). Metformin was by far the most widely used non-insulin antidiabetic drug with a prevalence proportion of 0.51/1000 in 2019, followed by glucagon-like peptide-1 (GLP-1) analogues, which, however, showed an eight-fold relative increase during the study period.
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Affiliation(s)
- Helene K Jensen
- Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Denmark
| | - Lotte Rasmussen
- Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Denmark
| | - Kari Furu
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Øystein Karlstad
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Marie Linder
- Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Carolyn E Cesta
- Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Anton Pottegård
- Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Denmark
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Chao YS, Wu CJ, Wu HC, Chen WC. Drug trends among non-institutionalized Canadians and the impact of data collection changes in the Canadian Health Measures Survey 2007 to 2015. PLoS One 2019; 14:e0214718. [PMID: 30978234 PMCID: PMC6461261 DOI: 10.1371/journal.pone.0214718] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 03/19/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND There is a global trend of increasing use in prescription and over-the-counter (OTC) drugs. This hasn't been verified in Canada. In addition, there are changes made to the collection method of medication information after the Canadian Health Measures Survey (CHMS) cycle 2. This study aims to review the potential impact of the changes in medication data collection and the trends in medication use if data quality remains similar throughout the CHMS cycles 1 to 4. This is fundamental for the analysis of this biomonitoring database. METHODS The CHMS cycle 1 to 4 medication and household data were used to study the trends of medication use between 2007 and 2015. The use of prescription or OTC drugs was grouped based on the first levels of the Anatomical Therapeutic Chemical (ATC) Classification system. The total numbers of medications were asked in all cycles. However, only a maximum of 15 and 5 drugs could be respectively reported for existing and new prescription or OTC drugs in cycles 1 and 2. There were no restrictions on drug reporting after cycle 2. The trends of medication use were described as ratios, compared to cycle 1. RESULTS The total numbers of the types of medication ever identified decreased from 739 to 603 between cycles 1 and 4. The proportions of using any drugs were from 0.90 to 0.88 between cycles 1 and 4 (ratio = 1.08 in cycle 4, 95% CI = 0.89 to 1.26). The numbers of drugs in use were from 3.9 to 3.8 (ratio = 1.05 in cycle 4, 95% CI = 0.86 to 1.24). The proportions of prescription drug use were from 0.53 to 0.55 (ratio = 1.13 in cycle 4, 95% CI = 0.89 to 1.37), while the numbers of prescription were from 1.51 to 1.68 (ratio = 1.20 in cycle 4, 95% CI = 0.92 to 1.48). The use of diabetes and thyroid medication had trends similar to the respective disease prevalence. The use and the numbers of drugs for blood and blood forming organs significantly increased between cycles 1 and 4 (ratio = 1.56 in cycle 4, 95% CI = 1.03 to 2.10). CONCLUSIONS There is an increasing trend in the use of blood and blood forming agents through cycles 2 to 4 and cardiovascular drugs in cycle 3. For diabetes and thyroid medication, the proportions of medication use increase proportionally with disease prevalence. The changes in the medication information collection method may not have important impact on the reporting of the use of prescription or OTC drugs.
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Affiliation(s)
- Yi-Sheng Chao
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Université de Montréal, Montréal, Québec, Canada
| | - Chao-Jung Wu
- Département d'informatique, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Hsing-Chien Wu
- Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Wei-Chih Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine and Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Preissner S, Siramshetty VB, Dunkel M, Steinborn P, Luft FC, Preissner R. Pain-Prescription Differences - An Analysis of 500,000 Discharge Summaries. Curr Drug Res Rev 2019; 11:58-66. [PMID: 30207223 DOI: 10.2174/1874473711666180911091846] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/30/2018] [Accepted: 09/03/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Pain-relief prescriptions have led to an alarming increase in drug-related abuse. OBJECTIVE In this study, we estimate the pain reliever prescription rates at a major German academic hospital center and compare with the nationwide trends from Germany and prescription reports from the USA. METHODS We analysed >500,000 discharge summaries from Charité, encompassing the years 2006 to 2015, and extracted the medications and diagnoses from each discharge summary. Prescription reports from the USA and Germany were collected and compared with the trends at Charité to identify the frequently prescribed pain relievers and their world-wide utilization trends. The average costs of pain therapy were also calculated and compared between the three regions. RESULTS Metamizole (dipyrone), a non-opioid analgesic, was the most commonly prescribed pain reliever at Charité (59%) and in Germany (23%) while oxycodone (29%), a semi-synthetic opioid, was most commonly ordered in the USA. Surprisingly, metamizole was prescribed to nearly 20% of all patients at Charité, a drug that has been banned for safety reasons (agranulocytosis) in most developed countries including Canada, United Kingdom, and USA. A large number of prospective cases with high risk for agranulocytosis and other side effects were found. The average cost of pain therapy greatly varied between the USA (125.3 EUR) and Charité (17.2 EUR). CONCLUSION The choice of pain relievers varies regionally and is often in disagreement with approved indications and regulatory guidelines. A pronounced East-West gradient was observed with metamizole use and the opposite with prescription opioids.
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Affiliation(s)
- Saskia Preissner
- Dental, Oral and Maxillary Medicine, Department of Operative Dentistry, Charite - University Medicine Berlin, Berlin, Germany
| | - Vishal B Siramshetty
- Structural Bioinformatics Group, Experimental and Clinical Research Centre, Charite - University Medicine Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany
- BB3R - Berlin Brandenburg 3R Graduate School, Free University of Berlin, Berlin, Germany
| | - Mathias Dunkel
- Structural Bioinformatics Group, Institute of Physiology, Charite - University Medicine Berlin, Berlin, Germany
| | - Paul Steinborn
- Structural Bioinformatics Group, Experimental and Clinical Research Centre, Charite - University Medicine Berlin, Berlin, Germany
| | - Friedrich C Luft
- Experimental and Clinical Research Centre and Max-Delbrück Centre for Molecular Medicine, Berlin, Germany; The Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States
| | - Robert Preissner
- Structural Bioinformatics Group, Experimental and Clinical Research Centre, Charite - University Medicine Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany
- BB3R - Berlin Brandenburg 3R Graduate School, Free University of Berlin, Berlin, Germany
- Structural Bioinformatics Group, Institute of Physiology, Charite - University Medicine Berlin, Berlin, Germany
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van Rongen A, van der Aa MP, Matic M, van Schaik RHN, Deneer VHM, van der Vorst MM, Knibbe CAJ. Increased Metformin Clearance in Overweight and Obese Adolescents: A Pharmacokinetic Substudy of a Randomized Controlled Trial. Paediatr Drugs 2018; 20:365-374. [PMID: 29748932 PMCID: PMC6028885 DOI: 10.1007/s40272-018-0293-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND In view of the increased use of metformin in obese adolescents, the aim of this study was to determine the pharmacokinetics of metformin in overweight and obese adolescents. METHODS In overweight and obese adolescents receiving metformin 500 or 1000 mg twice daily for 37 weeks during a clinical trial, blood samples were collected over 8 h during an oral glucose tolerance test. Population pharmacokinetic modeling was performed using NONMEM. RESULTS Data for 22 overweight and obese adolescents with a mean total body weight (TBW) of 79.3 kg (range 54.7-104.9), body mass index (BMI) of 29.1 kg/m2 (range 22.9-39.3), and age of 15.9 years (range 11.1-17.5) were analysed. In the model, oral clearance (CL/F) of metformin (1.17 l/min [relative standard error of 6%]) increased significantly with TBW (p < 0.01). More specifically, CL/F increased with both developmental weight (WTfor age and length) and excess body weight (WTexcess), for which an excess weight covariate model was proposed. CONCLUSION The CL/F of metformin in obese adolescents (1.17 l/min) is larger than that in non-obese children (0.55 l/min) and similar to that in adults (1.3 l/min) as reported in the literature. This increase may potentially be explained by increased tubular secretion of metformin. These results appear to indicate that adult dosages of metformin could be considered in obese adolescents if pediatric dosages have been therapeutically ineffective. CLINICALTRIALS.GOV: NCT01487993.
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Affiliation(s)
- Anne van Rongen
- Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, The Netherlands ,Division of Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands ,Present Address: Department of Clinical Pharmacy, Reinier de Graaf Hospital, Delft, The Netherlands
| | | | - Maja Matic
- Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ron H. N. van Schaik
- Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Vera H. M. Deneer
- Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, The Netherlands ,Present Address: Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Catherijne A. J. Knibbe
- Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, The Netherlands ,Division of Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
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Rashed AN, Wong ICK, Wilton L, Tomlin S, Neubert A. Drug Utilisation Patterns in Children Admitted to a Paediatric General Medical Ward in Five Countries. Drugs Real World Outcomes 2015; 2:397-410. [PMID: 26690854 PMCID: PMC4674526 DOI: 10.1007/s40801-015-0049-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective To investigate and compare drug prescription patterns in children admitted to a paediatric general medical ward in five countries. Methods A prospective cohort study conducted on paediatric medical wards in the UK, Germany, Australia, Hong Kong (HK) and Malaysia. Data were collected over 3 months in each country except in Australia (1 month). All medications prescribed were classified according to the WHO Anatomical Therapeutic Chemical (ATC) classification. For each drug, frequency of prescriptions and patient exposures were calculated for ATC anatomical and therapeutic levels overall and by country. Results One thousand two hundred and seventy-eight patients were included (Australia 146, Germany 376, UK 313, HK 143 and Malaysia 300); 89.2 % of patients (1140) received medications, median 3 (interquartile range 2–5) drugs per patient. 5367 drugs were prescribed. The most frequently prescribed therapeutic groups in all countries were: systemic antibacterials (1355; 25.2 %), analgesics/non-steroidal anti-inflammatory drugs (NSAIDs) (1173; 21.8 %) and drugs for obstructive airway diseases (472; 8.8 %). Overall, 65.1 % (742) of patients received at least one systemic antibacterial, 63.7 % (726) received one or more analgesic/NSAIDs, and 23.6 % (269) received ‘drugs for obstructive airway diseases’. The number of patients exposed to these groups differed significantly between countries (p < 0.05). Paracetamol was the most frequently prescribed in all countries, but metamizole was only used in Germany. Morphine was mainly prescribed in the UK. Conclusion This study provides an overview of drug use patterns in five culturally and ethnically diverse countries. The most frequently used therapeutic groups were similar, but the proportion of patients treated differed between countries. Also within a therapeutic group the specific drug used varied between countries.
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Affiliation(s)
- Asia N Rashed
- Institute of Pharmaceutical Science, King's College London, King's Health Partners, 150 Stamford Street, London, SE1 9NH UK ; Pharmacy Department, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, Westminster Bridge Road, London, SE1 7EH UK
| | - Ian C K Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China ; UCL School of Pharmacy, London, UK
| | | | - Stephen Tomlin
- Institute of Pharmaceutical Science, King's College London, King's Health Partners, 150 Stamford Street, London, SE1 9NH UK ; Pharmacy Department, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, Westminster Bridge Road, London, SE1 7EH UK
| | - Antje Neubert
- Department of Paediatric and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
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Fazeli Farsani S, Souverein PC, Overbeek JA, van der Vorst MMJ, Knibbe CAJ, Herings RMC, de Boer A, Mantel-Teeuwisse AK. Long term trends in oral antidiabetic drug use among children and adolescents in the Netherlands. Br J Clin Pharmacol 2015; 80:294-303. [PMID: 25683632 DOI: 10.1111/bcp.12608] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 02/07/2015] [Accepted: 02/10/2015] [Indexed: 12/18/2022] Open
Abstract
AIM The aim of the study was to document long term trends in oral antidiabetic drug (OAD) use among children and adolescents in the Netherlands. METHODS A population-based cohort study was conducted using the Dutch PHARMO Database Network. All patients younger than 20 years old with at least one OAD dispensing were identified. Age-adjusted and age-specific incidence (1999-2011) and prevalence (1998-2011) rates of OAD use were calculated. Trends over time were assessed using joinpoint regression software. A subset of PHARMO Database Network (including community pharmacy dispensing records linked to general practitioner data (OPD-GP database)) was used to assess indications for OADs. RESULTS In 2011, the overall age-adjusted incidence and prevalence rates of OAD use were 20.7/100 000 (95% CI 19.2, 22.1) person-years (PY) and 53.8/100 000 (95% CI 51.5, 56.1) persons, respectively. The average annual percentage change (AAPC) in the overall age-adjusted incidence rates from 1999 to 2011 was 18.9% (95% CI 4.5, 35.2). The incidence and prevalence rates of OAD use were higher among females and older age categories. The increases in rates of OAD use were mainly driven by metformin. For only 50% of the 98 patients in the OPD-GP database, indications for OAD prescriptions were reported with type 1 diabetes (n = 20), type 2 diabetes (n = 16), and overweight/obesity (n = 10). CONCLUSIONS Incidence and prevalence rates of OAD use in children and adolescents substantially increased in the Netherlands, especially among older age categories (10-14 and 15-19 years) and females. The main indications for use of OADs were type 1 and 2 diabetes and overweight/obesity.
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Affiliation(s)
- S Fazeli Farsani
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - P C Souverein
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - J A Overbeek
- PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands
| | - M M J van der Vorst
- Department of Paediatrics, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - C A J Knibbe
- Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, the Netherlands.,Division of Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands
| | - R M C Herings
- PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.,Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - A de Boer
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - A K Mantel-Teeuwisse
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
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Johnsson IW, Haglund B, Ahlsson F, Gustafsson J. A high birth weight is associated with increased risk of type 2 diabetes and obesity. Pediatr Obes 2015; 10:77-83. [PMID: 24916852 DOI: 10.1111/ijpo.230] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 03/17/2014] [Accepted: 03/24/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND The association between low birth weight and adult disease is well known. Less is known on long-term effects of high birth weight. OBJECTIVE This study aims to investigate whether a high birth weight increases risk for adult metabolic disease. METHODS Swedish term single births, 1973-1982 (n = 759,999), were studied to age 27.5-37.5 years using Swedish national registers. Hazard ratios (HRs) were calculated in relation to birth weight for type 2 diabetes, obesity, hypertension and dyslipidaemia. RESULTS Men with birth weights between 2 and 3 standard deviation score (SDS) had a 1.9-fold increased risk (HR 1.91, 95% confidence interval [CI] 1.25-2.90) of type 2 diabetes, whereas those with birth weights above 3 SDS had a 5.4-fold increased risk (HR 5.44, 95% CI 2.70-10.96) compared to men with birth weights between -2 and 2 SDS. The corresponding HRs for women were 0.60 (95% CI 0.40-0.91) and 1.71 (95% CI 0.85-3.43) for birth weights 2-3 SDS and >3 SDS, respectively. Men with birth weights between 2 and 3 SDS had a 1.5-fold increased risk (HR 1.47, 95% CI 1.22-1.77) of obesity. The corresponding risk for women was 1.3-fold increased (HR 1.32, 95% CI 1.19-1.46). For men and women with birth weights above 3 SDS, the risks of adult obesity were higher, HR 2.46 (95% CI 1.63-3.71) and HR 1.85 (95% CI 1.44-2.37), respectively. CONCLUSIONS A high birth weight, particularly very high, increases the risk of type 2 diabetes in male young adults. The risk of obesity increases with increasing birth weight in both genders.
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Affiliation(s)
- I W Johnsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Wong ICK, Hsia Y. Authors' response to Bachmann and Hoffman's comments on psychopharmacological prescriptions for people with autism spectrum disorder (ASD): a multinational study. Psychopharmacology (Berl) 2015; 232:985-8. [PMID: 25627463 DOI: 10.1007/s00213-014-3859-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 06/02/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Ian C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China,
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Piovani D, Clavenna A, Bonati M. Drug use profile in outpatient children and adolescents in different Italian regions. BMC Pediatr 2013; 13:46. [PMID: 23557352 PMCID: PMC3623731 DOI: 10.1186/1471-2431-13-46] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 03/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Large differences exist in the prevalence rate of drugs prescribed to children and adolescents between and within countries. The aim of this study was to evaluate child and adolescent drug prescription patterns in Italy in an extra-hospital setting at the regional and Local Health Unit (LHU) levels. METHODS Data sources were three regional prescription databases. Data concerning the year 2008 were evaluated. A total of 3.3 million children and adolescents were included. Drug prevalence and prescription rates were evaluated at the regional and LHU levels. The correlation between mean latitude, average annual income, hospitalisation rate, number of paediatricians per 1,000 resident children, and prevalence rate was evaluated by LHU using a linear multiple regression analysis. RESULTS Large differences were found across Italian regions and LHUs. The mean prevalence rate was 56.4% (95% CI 56.3-56.5%; 51.2-65.4% among regions) and, at the LHU level, ranged from 43.1% to 70.0% (higher in the South). A total of 878 drugs were prescribed, 175 of which were shared by all LHUs. Amoxicillin clavulanate was the most used drug in all regions and in 31 of 33 LHUs. Amoxicillin was the drug with the highest variability in use between LHUs (9.1-52.1% of treated children). An inverse correlation was found between prevalence rate and both latitude (p < 0.0001) and average annual income (p = 0.0002). CONCLUSIONS The use of drugs in children and adolescents is higher in southern Italy and is inversely related to latitude and average annual income. More efforts should be devoted to informing physicians, patients and policy makers in order to plan effective initiatives to improve the situation.
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Affiliation(s)
- Daniele Piovani
- Department of Public Health, Laboratory for Mother and Child Health, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, 20156, Italy.
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Winnenburg R, Bodenreider O. Exploring pharmacoepidemiologic groupings of drugs from a clinical perspective. Stud Health Technol Inform 2013; 192:827-831. [PMID: 23920673 PMCID: PMC4304656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To investigate the extent to which pharmacoepidemiologic groupings are homogeneous in terms of clinical properties. METHODS In our analysis, we classified drug subgroups from the pharmacoepidemiologic Anatomical Therapeutic Chemical (ATC) classification system based on clinical drug properties. We established mappings from ATC fifth level drug entities to drug property annotations in the National Drug File Reference Terminology (NDF-RT), including therapeutic categories, mechanisms of action, and physiologic effects. Based on the annotations for the individual drugs we computed homogeneity scores for all ATC groups and analyzed their distribution. CONCLUSIONS We found ATC groups to be generally homogeneous, more so for mechanisms of action, and physiologic effects than for therapeutic intent. However, only half of all ATC drugs can be analyzed with this approach, in part because of missing properties in NDF-RT.
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