Abstract
Medicines are essential for the treatment of acute, communicable, and non-communicable diseases. The World Health Organization developed a toolkit for drug (medicine) utilization studies to assist in reviewing and evaluating the prescribing, dispensing, and use of medicines. There is a growing need for rigorous studies of medicine use in low- and middle-income countries (LMIC) using standard approaches, especially in the context of universal health coverage. This commentary provides a succinct summary of how to use the WHO anatomical therapeutic chemical (ATC)/defined daily dose (DDD) methodology in pharmacoepidemiological studies, with a focus on LMIC contexts. We drew on information from WHO resources and published literature, citing examples and case studies. We encourage readers to publish their drug utilization studies, although we caution about predatory journals. We recommend the use of the RECORD-PE initiative which focuses on methods for doing pharmacoepidemiological research and evaluating the quality of published papers.
Highlights
Medicines are essential for the treatment of acute, communicable, and non-communicable diseases and medical conditions, and include prescription, over the counter, and complementary and alternative medicines
Many low- and middle-income countries (LMIC) are working towards universal health coverage (UHC) where “all people [will] have access to needed health services of sufficient quality to be effective while ensuring that the use of these services does not expose the user to financial hardship” [1]
Together with the paucity of these studies from Asia, this provided the impetus for the authors to compile this commentary in which we aim to provide a succinct summary of how to use the anatomical therapeutic chemical (ATC)/defined daily dose (DDD) methodology in pharmacoepidemiological studies in adult populations, with a focus on LMIC contexts, drawing on information available from the World Health Organization (WHO) Collaborating Centre for Drug Statistics Methodology and WHO toolkit [8,11]
Summary
Medicines are essential for the treatment of acute, communicable, and non-communicable diseases and medical conditions, and include prescription, over the counter, and complementary and alternative medicines. Together with the paucity of these studies from Asia, this provided the impetus for the authors to compile this commentary in which we aim to provide a succinct summary of how to use the ATC/DDD methodology in pharmacoepidemiological studies in adult populations, with a focus on LMIC contexts, drawing on information available from the WHO Collaborating Centre for Drug Statistics Methodology and WHO toolkit [8,11] This commentary includes descriptions and explanations about the ATC classification system and the DDD, as well as how to perform relevant calculations; we provide examples of sources of data. There are additional considerations for drug utilization studies in children [12,13]
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