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Santoleri F, Musicco F, Fulgenzio C, Abrate P, Pestrin L, Pasut E, Modesti G, Giannini R, Rosa SD, Piccoli M, Mingolla G, Zuzolo E, Gazzola P, Roperti M, Pieri G, Montresor V, Martignoni I, Gambera M, Langella R, Tinari G, Spoltore C, Roberti C, Fabio LD, Grossi L, Guarino F, Vita FD, Lasala R, Costantini A. Adherence, persistence and treatment switching in psoriasis. Immunotherapy 2024. [PMID: 38651935 DOI: 10.2217/imt-2023-0343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Aim: This study aims to investigate drug utilization patterns in the treatment of psoriasis (PsO) from 1 to 5 years in a real-life setting with Adalimumab (Ada), Etanercept (Eta), Ustekinumab (Ust), Golimumab (Gol), Ixekizumab (Ixe), Secukinumab (Sec) and Apremilast (Apr). Materials & methods: Data from an observational study were used to calculate adherence using the Proportion of Days Covered (PDC) method and persistence. Results & conclusion: Treatment adherence was found to be good for all the drugs studied across all years of analysis, while persistence was suboptimal, showing a marked decrease from the third year of study onward. In the treatment of PsO, greater attention needs to be paid to treatment persistence.
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Affiliation(s)
| | - Felice Musicco
- San Gallicano Dermatological Institute - IRCCS, Rome Italy
| | | | | | | | - Enrico Pasut
- Service of Pharmacy, Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), Udine, Italy
| | - Germana Modesti
- Service of Pharmacy, Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), Udine, Italy
| | | | | | | | | | - Eva Zuzolo
- San Gallicano Dermatological Institute - IRCCS, Rome Italy
| | - Pietro Gazzola
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | | | | | | | - Marco Gambera
- "Ospedale P. Pederzoli" Casa di Cura Privata S.p.A.Via Monte Baldo
| | - Roberto Langella
- Pharmacy Department, Agency for Health Protection (ATS) of Milan,Italy
| | | | | | | | | | - Laura Grossi
- Chieti General Hospital, Via dei Vestini, Chieti Italy
| | | | | | - Ruggero Lasala
- Hospital Pharmacy of Corato, Local Health Unit of Bari, Bari, Italy
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Parabiaghi A, Monzio Compagnoni M, D’Avanzo B, Caggiu G, Galbussera AA, Tettamanti M, Fortino I, Barbato A. Association of Antipsychotic Polypharmacy and Two-Year All-Cause Mortality: A Population-Based Cohort Study of 33,221 Italian Continuous Users. J Clin Med 2024; 13:2073. [PMID: 38610838 PMCID: PMC11012528 DOI: 10.3390/jcm13072073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/23/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Differences in survival between patients treated with antipsychotic monotherapy vs. polytherapy are debated. This study aimed to examine the association of antipsychotic polytherapy with 2-year all-cause mortality in a population-based cohort. Methods: Data were retrieved from healthcare databases of four local health units of Lombardy, Italy. Subjects aged 18-79 years who received continuous antipsychotic prescriptions in 2018 were identified. Overall survival among patients with antipsychotic monotherapy vs. polytherapy was compared. A multivariate Cox PH model was used to estimate the association between antipsychotic therapy, or antipsychotic use (continuous vs. non-continuous), and all-cause mortality. Adjustments were made for the presence of metabolic disturbances, total antipsychotic dosage amount (olanzapine equivalent doses), age, and sex. Results: A total of 49,875 subjects receiving at least one prescription of antipsychotics during 2018 were identified. Among the 33,221 patients receiving continuative antipsychotic prescriptions, 1958 (5.9%) experienced death from any cause at two years. Patients with continuous antipsychotic use had a 1.13-point increased mortality risk compared with non-continuous users. Patients treated with antipsychotic polytherapy showed an adjusted mortality risk increased by 17% (95% CI: 2%, 33%) compared to monotherapy. Conclusions: The study highlights the potential risks associated with antipsychotic polypharmacy, emphasizing the importance of optimizing drug prescriptions to improve patient safety and reduce mortality rates in individuals receiving antipsychotic therapy.
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Affiliation(s)
- Alberto Parabiaghi
- Unit for Quality of Care and Rights Promotion in Mental Health, Istituto di Ricerche Farmacologiche “Mario Negri”-IRCCS, 20156 Milan, Italy; (A.P.); (A.B.)
| | - Matteo Monzio Compagnoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy;
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Barbara D’Avanzo
- Laboratory for Assessing Quality of Care and Services, Istituto di Ricerche Farmacologiche “Mario Negri”-IRCCS, 20156 Milan, Italy;
| | - Giulia Caggiu
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy;
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Mental Health and Addiction Services, ASST Lecco, 23900 Lecco, Italy
| | - Alessia A. Galbussera
- Laboratory of Geriatric Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri”-IRCCS, 20156 Milan, Italy; (A.A.G.); (M.T.)
| | - Mauro Tettamanti
- Laboratory of Geriatric Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri”-IRCCS, 20156 Milan, Italy; (A.A.G.); (M.T.)
| | - Ida Fortino
- Directorate General for Health, Lombardy Region, 00144 Milan, Italy
| | - Angelo Barbato
- Unit for Quality of Care and Rights Promotion in Mental Health, Istituto di Ricerche Farmacologiche “Mario Negri”-IRCCS, 20156 Milan, Italy; (A.P.); (A.B.)
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Chen TC, Wettermark B, Steinke D, Caughey GE, Tadrous M, Wirtz VJ, Chen LC. Feasibility and validity of using healthcare databases to conduct cross-national comparative studies of opioid use, its determinants and consequences. Pharmacoepidemiol Drug Saf 2023; 32:1021-1031. [PMID: 36942801 DOI: 10.1002/pds.5618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 02/28/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE A cross-national comparative (CNC) study about opioid utilization would allow the identification of strategies to improve pain management and mitigate risk. However, little is known about the accessibility and validity of information in healthcare databases internationally. This study aimed to identify the feasibility of using healthcare databases to conduct a CNC study of opioid utilization and its associated consequences. METHODS A cross-sectional survey was launched in March 2018, including experts interested in CNC studies comparing opioid utilization by purposeful sampling. An electronic survey was used to collect database characteristics, medicine information, and linkage information of each aggregate-level dataset (AD) and individual patient-level dataset (IPD). RESULTS Overall, participants from 21 geographical regions reported 18 ADs and 19 IPDs. Information on dispensed medications is available from 17 ADs and 17 IPDs. Of the 16 ADs that include primary care settings, only 9 ADs can obtain information from secondary care settings. Fourteen IPDs included patients' characteristics or could be retrieved from linkage databases. Although most ADs are publicly accessible (n = 13), only five IPDs can be accessed without extra cost. CONCLUSION Most ADs could be used to report opioid utilization in a primary care setting. IPDs with linkage databases should be applied to identify potential determinants, clinical outcomes, and policy impact. Data access restrictions and governance policies across jurisdictions can be challenging for timely analysis and require further collaboration.
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Affiliation(s)
- Teng-Chou Chen
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Björn Wettermark
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
- Pharmacy Center, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Douglas Steinke
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Gillian E Caughey
- Registry of Senior Australians, South Australian Health and Medical Research Institute and Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Mina Tadrous
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Veronika J Wirtz
- Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Li-Chia Chen
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Horváth L, Mirani S, Girgis MMF, Rácz S, Bácskay I, Bhattoa HP, Tóth BE. Six years' experience and trends of serum 25-hydroxy vitamin D concentration and the effect of vitamin D 3 consumption on these trends. Front Pharmacol 2023; 14:1232285. [PMID: 37521483 PMCID: PMC10374949 DOI: 10.3389/fphar.2023.1232285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction: Vitamin D (vitD) deficiency may have importance in some diseases, but there is a lack of data in our country to clarify the current situation. Our aim was to examine the basic characteristics of patients' vitD status, and the ratio of vitD deficiency and its relation to certain diseases, assess seasonality and trends, and reveal the indirect impact of the COVID-19 pandemic on vitD3 supplementation at the patient population level. Methods: Anonymized data on 25(OH)D test results were obtained from the clinical data registry of a tertiary teaching hospital covering the period between 1 January 2015 and 30 June 2021. VitD consumption (pharmacy sale) data were retrieved from the database of the National Health Insurance Fund of Hungary in order to calculate the defined daily dose (DDD)/1,000 inhabitants/day. Descriptive statistics and odds ratios with their 95% confidence intervals were calculated. The two-sample t-test and F-test were used to analyze our patients' data. Significant differences were considered if p <0.05. Results: Altogether, 45,567 samples were investigated; the mean age was 49 ± 19.1 years and 68.4% of them were female subjects. Overall, 20% of all patients had hypovitaminosis D, and just over 7% of patients had vitD deficiency. Male subjects had higher odds for hypovitaminosis or vitD deficiency (65.4 ± 28.2 nmol/L vs. 68.4 ± 28.4 nmol/L; p <0.0001). The mean 25(OH)D concentration has changed during the year, reaching a peak in September and a minimum in February. Patients with diseases of the circulatory system, genitourinary system, certain conditions originating in the perinatal period, and "sine morbo" (i.e., without a disease; such as those aged over 45 years and female teenagers) had statistically higher odds for lower 25(OH)D concentrations (p <0.00001). VitD consumption showed seasonality, being higher in autumn and winter. A slight increase started in the season of 2017/18, and two huge peaks were detected at the beginning of 2020 and 2021 in association with the COVID-19 waves. Conclusion: Our data are the first to describe data concerning vitD in our region. It reinforces the notion of vitD3 supplementation for some risk groups and also in healthy individuals. To prevent the winter decline, vitD3 supplementation should be started in September. This and the results during the COVID-19 pandemic highlight the importance of health education encouraging vitamin D3 supplementation.
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Affiliation(s)
- László Horváth
- Department of Pharmaceutical Surveillance and Economics, Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
| | - Sara Mirani
- Department of Pharmaceutical Surveillance and Economics, Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
| | - Michael Magdy Fahmy Girgis
- Department of Pharmaceutical Surveillance and Economics, Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
| | - Szilvia Rácz
- Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ildikó Bácskay
- Healthcare Industry Institute, University of Debrecen, Debrecen, Hungary
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Béla E. Tóth
- Department of Pharmaceutical Surveillance and Economics, Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
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Muacevic A, Adler JR, Kalathia M, Patel N, Shah S. Drug Utilization Study of Gastroprotective Agents in Medicine and Surgery Wards of a Tertiary Care Teaching Hospital. Cureus 2023; 15:e33739. [PMID: 36793848 PMCID: PMC9925038 DOI: 10.7759/cureus.33739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 01/15/2023] Open
Abstract
Introduction Drug utilization research (DUR) is "the marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social, and economic consequences" as per the definition of the World Health Organization (WHO). The ultimate goal of DUR is to evaluate whether the drug treatment is rational or not. Various gastroprotective agents are available today, such as proton pump inhibitors, antacids, and histamine 2A receptor antagonists (H2RAs). Proton pump inhibitors block the gastric H+/K+-adenosine triphosphatase (ATPase) via covalent binding to cysteine residues of the proton pump to inhibit gastric acid secretion. Antacids are compounds containing different combinations, such as calcium carbonate, sodium bicarbonate, aluminum, and magnesium hydroxide. Histamine 2A receptor antagonists (H2RAs) decrease gastric acid secretion by reversibly binding to histamine H2 receptors located on gastric parietal cells, thereby inhibiting the binding and action of the endogenous ligand histamine. A recent literature review has shown that inappropriate use of gastroprotective agents has increased the risk for adverse drug reactions (ADRs) and drug interactions. Methods A total of 200 inpatient prescriptions were analyzed. The extent of prescribing, dosing information given, and cost incurred on the use of gastroprotective agents in both surgery and medicine inpatient departments was assessed. Prescriptions were also analyzed using WHO core indicators and for drug-drug interactions. Results Proton pump inhibitors were prescribed to 112 male patients and 88 female patients. The most common diagnosis was diseases of the digestive system with 54 (27.5%) cases, followed by diseases of the respiratory tract with 48 (24%) cases. Out of 200 patients, 51 comorbidities were reported from 40 patients. Among all prescriptions, injection of pantoprazole was the most common route of administration (181 (90.5%)), followed by tablets of pantoprazole (19 (9.5%)). The most common dose prescribed of pantoprazole was 40 mg in 191 (95.5%) patients in both departments. The frequency of therapy was also most commonly prescribed twice daily (BD) in 146 (73%) patients. Potential drug interaction was most commonly found with aspirin in 32 (16%) patients. The total cost incurred on proton pump inhibitor therapy of the medicine and surgery departments was 20,637.4 Indian Rupees (INR). Of this, the cost for patients admitted in the medicine ward was 11,656.12 INR and in the surgery department was 8,981.28 INR. Conclusion Gastroprotective agents are a group of drugs that are used to protect the stomach and the gastrointestinal tract (GIT) from acid-related injury. Our study found that proton pump inhibitors were the most commonly prescribed gastroprotective agents among inpatient prescriptions, with pantoprazole being the most frequently used. The most common diagnosis among patients was diseases of the digestive system, and most of the prescriptions were for injection administration at a dose of 40 mg twice daily. These findings suggest that there may be opportunities for improvement in the rational use of gastroprotective agents to reduce the risk of adverse drug reactions and interactions and lower healthcare costs. Overall, the study highlights the need for healthcare providers to be aware of the appropriate use of gastroprotective agents to minimize irrational prescriptions and reduce polypharmacy.
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Barberato-Filho S, Bergamaschi CDC, Godman B, Silva MT, Del Fiol FDS, Baldoni AO, Barreto JOM, Lopes LC. Editorial: New Horizons in Health-Promoting: From Methods to Implementation Science. Front Pharmacol 2022; 12:830957. [PMID: 35095538 PMCID: PMC8795761 DOI: 10.3389/fphar.2021.830957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Silvio Barberato-Filho
- Pharmaceutical Science Graduate Course, University of Sorocaba (Uniso), Sorocaba, Brazil
| | | | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom.,Centre of Medical and Bio-allied Health Sciences Research, Ajman University, AlAin, United Arab Emirates.,School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, South Africa
| | - Marcus Tolentino Silva
- Pharmaceutical Science Graduate Course, University of Sorocaba (Uniso), Sorocaba, Brazil
| | | | | | | | - Luciane Cruz Lopes
- Pharmaceutical Science Graduate Course, University of Sorocaba (Uniso), Sorocaba, Brazil
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Tomas A, Aljadeeah S. The Overlooked Issue of Outpatient Combination Antibiotic Prescribing in Low- and Middle-Income Countries: An Example from Syria. Antibiotics (Basel) 2022; 11:74. [PMID: 35052951 DOI: 10.3390/antibiotics11010074] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/02/2022] [Accepted: 01/05/2022] [Indexed: 02/06/2023] Open
Abstract
This study aimed to determine and describe the prevalence of combination antibiotics dispensed in outpatients with health insurance in Syria. Data on all dispensed medicines between June 2018 and May 2019 for 81,314 adults were obtained, and medicines belonging to the J01 group of the World Health Organization (WHO) anatomical therapeutic classification (ATC) were included in the analysis. Prescriptions were stratified according to the number of antibiotics, age, and sex. Antibiotic utilization was expressed as the number of prescriptions per 1000 persons per year. Out of 59,404 prescriptions for antibiotics, 14.98% contained antibiotic combinations, distributed to 22.49% of the patients. The prevalence of dispensing antibiotic combinations was higher in female patients (23.00%), and the youngest (18–30 years, 26.19%) and oldest age groups (>70 years, 25.19%). The antibiotics most commonly combined were co-amoxiclav, second- and third-generation cephalosporins, and macrolides. Over 60% of the combinations contained ceftriaxone alone or in combination with sulbactam. The present study shows an alarmingly widespread prescription of antibiotic combinations, posing a risk to global health by promoting resistance development.
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Lopes LC, Salas M, Osorio-de-Castro CGS, Leal LF, Doubova SV, Cañás M, Dreser A, Acosta A, Baldoni AO, de Cássia Bergamaschi C, Mota DM, Gómez-Galicia DL, Sepúlveda-Viveros D, Delgado EN, da Costa Lima E, Chandia FV, Ferre F, Marin GH, Olmos I, Zimmermann IR, Fulone I, Roldán-Saelzer J, Sánchez-Salgado JC, Castro-Pastrana LI, de Souza LJC, Beltrán MM, Silva MT, Mena MB, de França Fonteles MM, Urtasun MA, Mónica Tarapués MD, Patricia Granja Hernández MD, Medero N, Comoglio RH, Barberato-Filho S, Galvão TF, Luiza VL, Santa-Ana-Tellez Y, Tanta YR, Elseviers M. Data Sources for Drug Utilization Research in Latin American countries - a cross-national study: DASDUR-LATAM Study. Pharmacoepidemiol Drug Saf 2021; 31:343-352. [PMID: 34957616 DOI: 10.1002/pds.5404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE Drug utilization research (DUR) contributes to inform policymaking and to strengthen health systems. The availability of data sources is the first step for conducting DUR. However, documents that systematize these data sources in Latin American (LatAm) countries are not known. We compiled the potential data sources for DUR in the LatAm region. METHODS A network of DUR experts from nine LatAm countries was assembled and experts conducted: (i) a website search of the government, academic, and private health institutions; (ii) screening of eligible data sources, and (iii) liaising with national experts in pharmacoepidemiology (via an on-line survey). The data sources were characterized by accessibility, geographic granularity, setting, sector of the data, sources and type of the data. Descriptive analyses were performed. RESULTS We identified 125 data sources for DUR in nine LatAm countries. Thirty-eight (30%) of them were publicly and conveniently available; 89 (71%) were accessible with limitations, and 18 (14%) were not accessible or lacked clear rules for data access. From the 125 data sources, 76 (61%) were from the public sector only; 46 (37%) were from pharmacy records; 43 (34%) came from ambulatory settings and; 85 (68%) gave access to individual patient-level data. CONCLUSIONS Although multiple sources for DUR are available in LatAm countries, the accessibility is a major challenge. The procedures for accessing DUR data should be transparent, feasible, affordable and protocol-driven. This inventory could permit a comparison of drug utilization between countries identifying potential medication-related problems that need further exploration.
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Affiliation(s)
- Luciane C Lopes
- Pharmaceutical Science Graduate Course, Universidade de Sorocaba UNISO, Sao Paulo, Brazil.,Rodovia Raposo Tavares, Km 92, 5, Sorocaba, Sao Paulo, Brazil
| | - Maribel Salas
- Daiichi Sankyo, Inc., Address: 211 Mount Airy Road, 1A-453, Basking Ridge, New Jersey, USA.,CCEB/CPeRT., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Claudia Garcia Serpa Osorio-de-Castro
- National School of Public Health, Oswaldo Cruz Foundation (Ministry of Health), Rio de Janeiro, Brazil.,Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Lisiane Freitas Leal
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University/Centre for Clinical Epidemiology - Lady Davis Institute, Montreal, Canada, 3755 Côte-Ste-Catherine Road, Pavillion H-485, Montreal, QC, Canada
| | - Svetlana V Doubova
- National Medical Center Siglo XXI, Mexico, Mexican Institute of Social Security, Mexico City (IMSS), Av Cuahutemos 330. México City, Mexico
| | - Martín Cañás
- Federación Médica de la Provincia de Buenos Aires (FEMEBA), Argentina, Calle 5 N° 473, La Plata, Argentina
| | - Anahi Dreser
- Centre for Health Systems Research, National Institute of Public Health, Mexico, Av. Universidad 655, Cuernavaca, Morelos, Mexico
| | - Angela Acosta
- University of Sao Paulo Department of Public Health, São Paulo, SP, Brazil
| | - Andre Oliveira Baldoni
- Universidade Federal de São João Del-Rei (UFSJ), Dvinópolis, Brazil, R. Sebastião Gonçalves Coelho, 400 - Chanadour, Divinópolis, MG, Brazil
| | - Cristiane de Cássia Bergamaschi
- Pharmaceutical Science Graduate Course, Universidade de Sorocaba UNISO, Sao Paulo, Brazil.,Rodovia Raposo Tavares, Km 92, 5, Sorocaba, Sao Paulo, Brazil
| | - Daniel Marques Mota
- Brazilian Health Regulatory Agency, Brasilia, Brazil.,Setor de Indústria e Abastecimento (SIA) - Trecho 5, Área Especial 57, Brasília, DF, Brazil
| | - Diana L Gómez-Galicia
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Mexico, Cuernavaca, Mexico
| | | | | | - Elisangela da Costa Lima
- School of Pharmacy, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Avenida Carlos Chagas Filho, 373, Cidade Universitária, Rio de Janeiro, RJ, Brazil
| | - Felipe Vera Chandia
- Unidad de Evaluación de Tecnologías en Salud, Centro de Investigación Clínica, Pontificia Universidad Católica de Chile., Chile, Avda. Libertador Bernando O'Higgins 340, Santiago, Chile
| | - Felipe Ferre
- Federal University of Minas Gerais - School of Medicine, Minas Gerais, Brazil, Av. Prof. Alfredo Balena, 190 - sala 503 / Belo Horizonte - MG zip 30130-100
| | - Gustavo H Marin
- Faculty of Medicine, National University of La Plata - CONICET, Argentina, Calle 60 y 120 (1900) La Plata, Argentina
| | - Ismael Olmos
- Servicios de Salud del Estado, Uruguay / Milán, Uruguay
| | - Ivan R Zimmermann
- Department of Public Health, University of Brasilia, Campus Darcy Ribeiro, Asa Norte, Brasilia, DF, Brazil
| | - Izabela Fulone
- Pharmaceutical Science Graduate Course, Universidade de Sorocaba UNISO, Sao Paulo, Brazil.,Rodovia Raposo Tavares, Km 92, 5, Sorocaba, Sao Paulo, Brazil
| | - Juan Roldán-Saelzer
- Instituto de Salud Publica de Chile, Santiago, Chile, Marathon 1000, Nunoa, Santiago, Chile
| | | | - Lucila I Castro-Pastrana
- Department of Chemical and Biological Sciences, Universidad de las Américas Puebla, Mexico.,ExHacienda de Santa Catarina Mártir s/n, 72810, San Andrés Cholula, Puebla, Mexico
| | - Luiz Jupiter Carneiro de Souza
- Oswaldo Cruz Foundation (Ministry of Health), Brasilia, Brazil.,Avenida L3 Norte, no number, Darcy Ribeiro University Campus (University of Brasília - UNB), Gleba A -ZIP Code: 70.904-130 - Brasília - DF, Brazil
| | | | - Marcus Tolentino Silva
- Pharmaceutical Science Graduate Course, Universidade de Sorocaba UNISO, Sao Paulo, Brazil.,Rodovia Raposo Tavares, Km 92, 5, Sorocaba, Sao Paulo, Brazil
| | - María Belén Mena
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador, Calle Sodiro e Iquique Quito-Ecuador
| | - Marta Maria de França Fonteles
- Universidade Federal do Ceará (UFC), Fortaleza, Ceará, Brazil, Rua Pastor Samuel Munguba, 1210, Rodolfo Teófilo, Fortaleza- Ceará, 60430-372, Brazil
| | - Martín A Urtasun
- Federación Médica de la Provincia de Buenos Aires (FEMEBA), Argentina, Calle 5 N° 473, La Plata, Argentina
| | - M D Mónica Tarapués
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador, Calle Sodiro e Iquique Quito-Ecuador
| | - M D Patricia Granja Hernández
- Hivos - Humanistic Organization for Social Change, Quito, Ecuador, Av. Amazonas 239 (entre 18 de septiembre y Jorge Washington) Quito - Ecuador
| | - Natalia Medero
- Servicios de Salud del Estado (ASSE), Montevedeo, Uruguay, Luis Alberto de Herrera 3326, Montevideo, Uruguay
| | - Raquel Herrera Comoglio
- Hospital Nacional de Clínicas, Pharmacovigilance Service, Buenos Aires, Argentina, Santa Rosa 1564, X5000 ETF, Córdoba, Argentina
| | - Silvio Barberato-Filho
- Pharmaceutical Science Graduate Course, University of Sorocaba, São Paulo, Brazil, Rodovia Raposo Tavares, Km 92,5, Sorocaba, São Paulo, Brazil
| | - Taís Freire Galvão
- Universidade Estadual de Campinas, Faculdade de Ciências Farmacêuticas, Campinas, Brazil, R. Cândido Portinari, 200 - Cidade Universitária Zeferino Vaz Campinas/SP 13083-871
| | - Vera Lucia Luiza
- National School of Public Health, Oswaldo Cruz Foundation (Ministry of Health), Rio de Janeiro, Brazil.,Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Yared Santa-Ana-Tellez
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Netherlands, David de Wiedgebouw, Universiteitsweg 99, Utrecht, Netherlands
| | - Yesenia Rodríguez Tanta
- Institute of Health and Technology Assessment and Research - Social Security of Peru (ESSALUD), Lima, Peru, Jirón Domingo Cueto 109, Jesús María 15072 - Lima, Peru
| | - Monique Elseviers
- Department of Clinical Pharmacology, University of Ghent, Belgium, Centre for Research and Innovation in Care, University of Antwerp, Belgium, Campus Drie Eiken, Building R - Office R. 214 Universiteitsplein 1 2610 WILRIJK (Antwerpen), Belgium
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9
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De Loof H, De Win E, Moens N, Verhoeven V, Van Royen P, Kreps EO, Philips H. Overprescribing of Topical Ocular Corticosteroids and Antibiotics in Out-of-Hours Primary Care in Belgium. Drug Healthc Patient Saf 2021; 13:229-232. [PMID: 34849033 PMCID: PMC8627259 DOI: 10.2147/dhps.s339141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/03/2021] [Indexed: 11/23/2022] Open
Abstract
Prescribing patterns by primary care physicians concerning ophthalmic problems were studied using the iCAREdata, a database containing information from the out-of-hours care setting in the Flanders region of Belgium. A very high percentage of prescribed ophthalmic medication was topical antibiotics (89.4%) with tobramycin as the most prevalent substance and in clear conflict with the prevailing guidelines. In addition, a very substantial fraction of prescribed medication contained corticosteroids (30.4%). This is a potentially unsafe option within the technical infrastructure of this setting, which limits the diagnostic possibilities concerning viral infections or preexisting glaucoma risk. We conclude that more efforts are required to limit unnecessary and inappropriate prescribing behavior to further promote patient safety.
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Affiliation(s)
- Hans De Loof
- Laboratory of Physiopharmacology, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium
| | - Ellen De Win
- Laboratory of Physiopharmacology, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium
| | - Nathalie Moens
- Laboratory of Physiopharmacology, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium
| | - Veronique Verhoeven
- Research Group, Primary and Interdisciplinary Care (ELIZA), Department Family Medicine and Population Health (FAMPOP) University of Antwerp, Antwerp, Belgium
| | - Paul Van Royen
- Research Group, Primary and Interdisciplinary Care (ELIZA), Department Family Medicine and Population Health (FAMPOP) University of Antwerp, Antwerp, Belgium
| | - Elke O Kreps
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| | - Hilde Philips
- Research Group, Primary and Interdisciplinary Care (ELIZA), Department Family Medicine and Population Health (FAMPOP) University of Antwerp, Antwerp, Belgium
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10
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Abstract
Drug utilization studies in developing countries is evolving. Rising medication cost for hypertensive patients is a major cause of noncompliance to therapy. The study was a cross-sectional drug utilization review involving outpatients in two purposively selected hospitals (secondary and tertiary) in Abeokuta, Southwestern Nigeria. Data and relevant information were obtained from the patients' medical records domiciled in the outpatients' hospital records department. Descriptive and inferential statistics were used at p < 0.05. Total medication cost to patients was USD$48,575; out of which antihypertensive medications accounted for 46% (USD$21,588) in two referral hospitals. Ramipril was the most prescribed in both hospitals. Generic drugs were cheaper than their branded alternatives. Study outcomes are beneficial for managing costs for hypertensive patients.
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Affiliation(s)
- Theophilus Ehidiamen Oamen
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, Obafemi Awolowo University, Ife, Osun State, Nigeria
| | - Kanayo Patrick Osemene
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, Obafemi Awolowo University, Ife, Osun State, Nigeria
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11
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Tomas A, Pavlović N, Stilinović N, Horvat O, Paut-Kusturica M, Dugandžija T, Tomić Z, Sabo A. Increase and Change in the Pattern of Antibiotic Use in Serbia (2010-2019). Antibiotics (Basel) 2021; 10:397. [PMID: 33916896 PMCID: PMC8067575 DOI: 10.3390/antibiotics10040397] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 01/01/2023] Open
Abstract
The aim of this study was to determine and describe trends in antibiotics utilization in Serbia over a ten-year period. Data were retrieved from publicly available annual reports (2010-2019). The results were expressed as Defined Daily Dose (DDD) per 1000 inhabitants per day (DID). All calculations were performed using the DDD values for the 2020 Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) version for each year of the study, to account for the DDD changes during the study period. Antibiotics were classified using the WHO Access, Watch, Reserve (AWaRe) classification. Total utilization of antibacterials for systemic use increased from 17.25 DID in 2010 to 28.65 DID in 2019. A statistically significant increasing trend in the use of the Watch category antibiotics was observed. A tendency towards use of broad-spectrum antibiotics, apparent by a statistically significant increase in the rate of utilization of broad-spectrum macrolides, quinolones and third-generation cephalosporins vs. narrow-spectrum ones, as well as a significant increasing trend in the use of quinolones was identified. Total antibiotic utilization was found to be well above the European average. Several specific problem areas were identified, which requires further efforts to improve antibiotic prescribing. The present study provides the information needed to facilitate antibiotic stewardship in Serbia further and proposes specific interventions to optimize antibiotic use in Serbia.
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Affiliation(s)
- Ana Tomas
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia; (N.S.); (O.H.); (M.P.-K.); (Z.T.); (A.S.)
| | - Nebojša Pavlović
- Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia;
| | - Nebojša Stilinović
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia; (N.S.); (O.H.); (M.P.-K.); (Z.T.); (A.S.)
| | - Olga Horvat
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia; (N.S.); (O.H.); (M.P.-K.); (Z.T.); (A.S.)
| | - Milica Paut-Kusturica
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia; (N.S.); (O.H.); (M.P.-K.); (Z.T.); (A.S.)
| | - Tihomir Dugandžija
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia;
- Oncology Institute of Vojvodina, Put doktora Goldmana 4, 21204 Sremska Kamenica, Serbia
| | - Zdenko Tomić
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia; (N.S.); (O.H.); (M.P.-K.); (Z.T.); (A.S.)
| | - Ana Sabo
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia; (N.S.); (O.H.); (M.P.-K.); (Z.T.); (A.S.)
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12
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Lopes LC, Godman B, Bergamaschi CDC, Barberato-Filho S, Silva MT. Editorial: New Horizons in Health-Promoting Technologies: From Development to Rational Use. Front Pharmacol 2020; 11:1180. [PMID: 32848783 PMCID: PMC7424042 DOI: 10.3389/fphar.2020.01180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/20/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Luciane Cruz Lopes
- Pharmaceutical Science Graduate Course, University of Sorocaba, Sorocaba, Brazil
| | - Brian Godman
- Karolinska University Hospital Huddinge, Karolinska Institutet (KI), Stockholm, Sweden.,Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom.,School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, South Africa
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13
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Salas M, Lopes LC, Godman B, Truter I, Hartzema AG, Wettermark B, Fadare J, Burger JR, Appenteng K, Donneyong M, Arias A, Ankrah D, Ogunleye OO, Lubbe M, Horne L, Bernet J, Gómez-Galicia DL, Del Carmen Garcia Estrada M, Oluka MN, Massele A, Alesso L, Herrera Comoglio R, da Costa Lima E, Vilaseca C, Bergman U. Challenges facing drug utilization research in the Latin American region. Pharmacoepidemiol Drug Saf 2020; 29:1353-1363. [PMID: 32419226 DOI: 10.1002/pds.4989] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 12/20/2019] [Accepted: 02/03/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE The International Society of Pharmacoepidemiology (ISPE) in collaboration with the Latin America Drug Utilization Research Group (LatAm DURG), the Medicines Utilization Research in Africa (MURIA) group, and the Uppsala Monitoring Center, is leading an initiative to understand challenges to drug utilization research (DUR) in the Latin American (LatAm) and African regions with the goal of communicating results and proposing solutions to these challenges in four scientific publications. The purpose of this first manuscript is to identify the main challenges associated with DUR in the LatAm region. METHODS Drug utilization (DU) researchers in the LatAm region voluntarily participated in multiple discussions, contributed with local data and reviewed successive drafts and the final manuscript. Additionally, we carried out a literature review to identify the most relevant publications related to DU studies from the LatAm region. RESULTS Multiple challenges were identified in the LatAm region for DUR including socioeconomic inequality, access to medical care, complexity of the healthcare system, limited investment in research and development, limited institutional and organization resources, language barriers, limited health education and literacy. Further, there is limited use of local DUR data by decision makers particularly in the identification of emerging health needs coming from social and demographic transitions. CONCLUSIONS The LatAm region faces challenges to DUR which are inherent in the healthcare and political systems, and potential solutions should target changes to the system.
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Affiliation(s)
- Maribel Salas
- Daiichi Sankyo, Inc, Basking Ridge, USA.,CCEB/CPeRT, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Luciane C Lopes
- Pharmaceutical Science graduate Course, Universidade de Sorocaba UNISO, Sao Paulo, Brazil
| | - Brian Godman
- Karolinska Institute, Stockholm, Sweden.,Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Gainesville, Glasgow, UK.,School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, South Africa
| | - Ilse Truter
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Nelson Mandela University, South Africa
| | | | - Bjorn Wettermark
- Clinical epidemiology & Clinical pharmacology, Karolinska Institutet, Stockholm, Sweden.,Department of Pharmacy, Disciplinary Domain of Medicine and Pharmacy, Uppsala University
| | - Joseph Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University College of Medicine, Ado-Ekiti, Nigeria
| | - Johanita R Burger
- Medicine Usage in South Africa (MUSA), North-West University, Potchefstroom, South Africa
| | - Kwame Appenteng
- Department of Epidemiology, Astellas Pharma US, Northbrook, IL
| | - Macarius Donneyong
- Pharmacy Practice and Science, College of Pharmacy, The Ohio State University, Columbus, Ohio
| | - Ariel Arias
- Centre for Biologics Evaluation, Health Canada, Ottawa, ON and Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada
| | | | - Olayinka O Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Martha Lubbe
- Medicine Usage in South Africa (MUSA), North-West University, Potchefstroom, South Africa
| | - Laura Horne
- Department of Epidemiology, Daiichi Sankyo, Inc, Basking Ridge, NJ
| | - Jorgelina Bernet
- School of Medicine, Cordoba National University, Cordoba, Argentina
| | - Diana L Gómez-Galicia
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Cuernavaca, México
| | | | | | - Amos Massele
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Luis Alesso
- School of Medicine, Cordoba National University, Cordoba, Argentina
| | | | - Elisangela da Costa Lima
- Observatorio de Vigilancia e Uso de Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ
| | - Carmen Vilaseca
- Colegio de Bioquimica y Farmacia, La Paz, Bolivia, Plurinational State
| | - Ulf Bergman
- Departments of Clinical Pharmacology and Pharmacoepidemiology, Karolinska Institutet, Karolinska University Hospital, Huddinge
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14
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Visser JC, Wibier L, Kiefer O, Orlu M, Breitkreutz J, Woerdenbag HJ, Taxis K. A Pediatrics Utilization Study in The Netherlands to Identify Active Pharmaceutical Ingredients Suitable for Inkjet Printing on Orodispersible Films. Pharmaceutics 2020; 12:pharmaceutics12020164. [PMID: 32079184 PMCID: PMC7076503 DOI: 10.3390/pharmaceutics12020164] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 01/13/2023] Open
Abstract
Background: The use of medication in pediatrics, children aged 0–5 years, was explored so as to identify active pharmaceutical ingredients (APIs) suitable for inkjet printing on a plain orodispersible film (ODF) formulation in a pharmacy. Methods: The database IADB.nl, containing pharmacy dispensing data from community pharmacies in the Netherlands, was used to explore medication use in the age group of 0–5 years old, based on the Anatomical Therapeutic Chemical classification code (ATC code). Subsequently, a stepwise approach with four exclusion steps was used to identify the drug candidates for ODF formulation development. Results: there were 612 Active Pharmaceutical Ingredients (APIs) that were dispensed to the target group, mostly antibiotics. Of the APIs, 221 were not registered for pediatrics, but were used off-label. After the exclusion steps, 34 APIs were examined regarding their suitability for inkjet printing. Almost all of the APIs were sparingly water soluble to practically insoluble. Conclusion: Pharmaceutical inkjet printing is a suitable new technique for ODF manufacturing for pediatric application, however the maximal printed dose as found in the literature remained low. From the selected candidates, only montelukast shows a sufficiently high water-solubility to prepare a water-based solution. To achieve higher drug loads per ODF is ambitious, but is theoretically possible by printing multiple layers, using highly water-soluble APIs or highly loaded suspensions.
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Affiliation(s)
- J. Carolina Visser
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (L.W.); (H.J.W.)
- Correspondence: ; Tel.: +31-50-3633282; Fax: +31-50-3632500
| | - Lisa Wibier
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (L.W.); (H.J.W.)
- Department of PharmacoTherapy, Epidemiology and Economics, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
| | - Olga Kiefer
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany; (O.K.); (J.B.)
| | - Mine Orlu
- School of Pharmacy, University College London, London WC1N 1AX, UK;
| | - Jörg Breitkreutz
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany; (O.K.); (J.B.)
| | - Herman J. Woerdenbag
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (L.W.); (H.J.W.)
| | - Katja Taxis
- Department of PharmacoTherapy, Epidemiology and Economics, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
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15
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Ankrah D, Hallas J, Odei J, Asenso-Boadi F, Dsane-Selby L, Donneyong M. A review of the Ghana National Health Insurance Scheme claims database: possibilities and limits for drug utilization research. Basic Clin Pharmacol Toxicol 2018; 124:18-27. [PMID: 30260590 DOI: 10.1111/bcpt.13136] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/18/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND There are inadequate data on prescribed drug utilization in Sub-Saharan Africa (SSA). Drug utilization research (DUR) in this region is hampered by lack of access to databases that capture prescribed drug utilization such as health insurance claims, electronic medical records and disease registries. The primary objective of this MiniReview was to describe the content of the NHIS claims database in the context of the health care system in Ghana. We will also review the possibilities and limitations of analysing this novel database for drug utilization research (DUR) in Ghana. METHODS We reviewed the history, composition of the database, coverage and health systems in Ghana. To demonstrate the application of the NHIS claims database for DUR, we reviewed the NHIS' drug formulary (NHIS medicines' list), assessed and quantified the utilization of the top 25 most commonly prescribed medicines and their distributions by age, sex, region of residence and by MDCs. RESULTS As of December 2014, about 40% (~10.5 million) of the Ghanaian population were active beneficiaries of NHIS. There were 1.43 million unique patients in the NHIS claims database who received services from about 81 providers located in 9 out of the 10 regions in Ghana. The mean age of this sample of beneficiaries was 31 (standard deviation, 22) years, a third of whom were aged <18 years old. Nearly, 2 out of every 3 beneficiaries were females. On average, there were approximately 3 outpatient visits per beneficiary in 2015. There were about 522 unique drugs on the NHIS medicine list. Overall, analgesic was the most prescribed class of medicine (mostly paracetamol and diclofenac). Antimalarials, artemether-lumefantrine, were observed as the second most prescribed medicines followed by anti-infectives (metronidazole) and antihypertensives (amlodipine). CONCLUSION The Ghana NHIS claims database is a great resource for DUR. This database could also be extended to facilitate pharmacoepidemiological and other health services' research especially if transformed into one of the existing standardized common data models.
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Affiliation(s)
- Daniel Ankrah
- College of Pharmacy, The Ohio State University, Columbus, Ohio.,Korle-Bu Teaching Hospital, Accra, Ghana
| | - Jesper Hallas
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - James Odei
- College of Public Health, The Ohio State University, Columbus, Ohio
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16
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Durán CE, Christiaens T, Acosta Á, Vander Stichele R. Systematic review of cross-national drug utilization studies in Latin America: methods and comparability. Pharmacoepidemiol Drug Saf 2015; 25:16-25. [PMID: 26486230 DOI: 10.1002/pds.3896] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 09/01/2015] [Accepted: 09/22/2015] [Indexed: 11/09/2022]
Abstract
PURPOSE We systematically review the cross-national drug utilization studies performed in Latin America (LA) in order to analyze the methods applied and assess the validity of the data to ensure the comparability. METHODS A systematic search in Medline, Embase, and BIREME was performed. Drug utilization studies including LA countries and comparing drug exposure data on volume were included. The data validity was judged independently by two authors as having low, medium, high, or unclear risk of bias. RESULTS Out of 1191 articles, 25 were kept for full text reading. Finally, five studies were selected. Eight different Latin American countries were involved in the comparisons. The selected studies analyzed wholesale data from a private research company collecting information from the private healthcare sector. In three studies, a high risk of bias in the extrapolation method applied was identified. In one study, a risk of data collection bias was detected. The most frequent limitation detected by the original authors was related to the unavailability of information from the public sector in LA. CONCLUSION Drug utilization studies comparing data cross-nationally are scarce in LA. In general, validity of the comparisons is hampered by a potential risk of extrapolation bias given the lack of available data on drug consumption from the public healthcare sector. Setting up systems to remediate this situation is a future challenge for researchers and (supra)national authorities in the region.
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Affiliation(s)
- Carlos E Durán
- Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium.,Yachay Public Company, Quito, Ecuador
| | | | - Ángela Acosta
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
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17
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Murata K, Hinotsu S, Hamada S, Ezoe Y, Muto M, Kawakami K. The changing patterns of dispensing branded and generic drugs for the treatment of gastroesophageal reflux disease between 2006 and 2011 in Japan: a retrospective cohort study. BMC Health Serv Res 2015; 15:76. [PMID: 25885571 PMCID: PMC4350298 DOI: 10.1186/s12913-015-0734-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 02/12/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Despite rising healthcare costs, generic drugs are less frequently dispensed in Japan compared with other developed countries. This study aimed to describe changes in dispensing of branded and generic drugs and to explore possible factors that promote the use of generic drugs. METHODS We conducted a retrospective cohort study using a Japanese medical and pharmacy claims database. All proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2RAs) with indications for gastroesophageal reflux disease (GERD) described on Japanese labels were included. Patterns of dispensing branded and generic drugs for the treatment of GERD between 2006 and 2011 were analyzed. Multivariate logistic regression was applied to investigate factors associated with receiving generic drugs. RESULTS The study cohort included 14,590 patients (male: 50.2%, mean age: 43.1 years). Branded drugs for GERD were still frequently dispensed despite an increase in the share of generic drugs. Only 4.3% of patients who initially received branded drugs switched to generic drugs. The percentage of patients who received only generic drugs increased over time (6.5% to 22.1%). The frequency of generic drug dispensing was the highest in the setting where both prescription and dispensing were implemented in clinics (43.3%), while the lowest in the setting where both prescription and dispensing were implemented in hospitals (11.5%). Factors associated with receiving generic drugs included year of dispensing (adjusted OR 2.22, 95% CI 1.94 to 2.55 for 2009-11 v 2006-8), prescription and dispensing setting (OR 1.81, 95% CI 1.44 to 2.26 for prescription in hospitals and dispensing in community pharmacies; OR 2.21, 95% CI 1.80 to 2.72 for prescription in clinics and dispensing in community pharmacies; and OR 4.55, 95% CI 3.68 to 5.62 for prescription and dispensing in clinics v prescription and dispensing in hospitals) and H2RAs (OR 1.64, 95% CI 1.49 to 1.81 compared to PPIs). CONCLUSIONS The share of generic drugs for the treatment of GERD increased over time although branded drugs for GERD were still dispensed frequently. The use of generic drugs for GERD was influenced not only by government policies but also by changes in treatment approach and the setting of prescription and dispensing.
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Affiliation(s)
- Kyoko Murata
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Shiro Hinotsu
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan.
| | - Shota Hamada
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Yasumasa Ezoe
- Department of Therapeutic Oncology, Kyoto University Hospital, Kyoto, Japan.
| | - Manabu Muto
- Department of Therapeutic Oncology, Kyoto University Hospital, Kyoto, Japan.
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
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18
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Patel MK, Barvaliya MJ, Patel TK, Tripathi C. Drug utilization pattern in critical care unit in a tertiary care teaching hospital in India. Int J Crit Illn Inj Sci 2014; 3:250-5. [PMID: 24459622 PMCID: PMC3891191 DOI: 10.4103/2229-5151.124128] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aims: The aim of this study is to evaluate the drug utilization pattern and pharmacoeconomic analysis in critical care unit (CCU). Materials and Methods: Indoor case papers of patients admitted in CCU between January 2008 and December 2010 were analyzed for demographic variables; indications; duration of CCU stay; proportion of common drugs used. Use of antimicrobials was evaluated based on the culture report and empirical regimen used. Defined daily dose (DDD)/100 bed-days were calculated. Various World Health Organization prescribing indicators were evaluated. Cost of drugs was calculated from Indian Drug Review (2010). Results: A total of 397 cases were evaluated with a mean age of 44.62 years (95% confidence interval [CI]: 42.56-46.69). Average duration of CCU stay was 4.15 days (95% CI: 3.79-4.51). The average number of drugs prescribed per patient was 13.54 (95% CI: 13.05-14.04). Total drug utilization in terms of DDD/100 bed-days was 226.27. Metronidazole, cefotaxime, atropine, adrenaline, dopamine, dobutamine, deriphyllin, ranitidine, metoclopramide and furosemide were prescribed in more than 30% cases. Number of antimicrobials prescribed per patient was 2.50 (95% CI: 2.37-2.66). Cefotaxime + metronidazole (26.70%) were the most common empirical regimen used. Average cost of treatment per patient was Rs 3225.70 (95% CI: 2749.8-3701.6). Higher economic burden was noted among expired patients and admitted due to medical + surgical indication (P < 0.05). Conclusion: Poly-pharmacy and use of antimicrobials without culture report is a common problem in CCU.
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Affiliation(s)
- Mahendra K Patel
- Department of Pharmacology, Government Medical College, Bhavnagar, India
| | - Manish J Barvaliya
- Department of Pharmacology, Government Medical College, Bhavnagar, India
| | - Tejas K Patel
- Department of Pharmacology, GMERS Medical College, Gotri, Vadodara, Gujarat, India
| | - Cb Tripathi
- Department of Pharmacology, Government Medical College, Bhavnagar, India
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