Drug Utilization Trends Research Articles

Hospital Variability in the Use of Vasoactive Agents in Patients Hospitalized for Acute Decompensated Heart Failure for Clinical Phenotypes.

The absence of practice standards in vasoactive agent usage for acute decompensated heart failure has resulted in significant treatment variability across hospitals, potentially affecting patient outcomes. This study aimed to assess temporal trends and institutional differences in vasodilator and inotrope/vasopressor utilization among patients with acute decompensated heart failure, considering their clinical phenotypes. Data were extracted from a government-funded multicenter registry covering the Tokyo metropolitan area, comprising consecutive patients hospitalized in intensive/cardiovascular care units with a primary diagnosis of acute decompensated heart failure between January 2013 and December 2021. Clinical phenotypes, that is, pulmonary congestion or tissue hypoperfusion, were defined through a comprehensive assessment of clinical signs and symptoms, vital signs, and laboratory findings. We assessed the frequency and temporal trends in phenotype-based drug utilization of vasoactive agents and investigated institutional characteristics associated with adopting the phenotype-based approach using generalized linear mixed-effects models, with random intercepts to account for hospital-level variability. Among 37 293 patients (median age, 80 years; 43.7% female), 88.6% and 21.2% had pulmonary congestion and tissue hypoperfusion status, respectively. Throughout the study period, both overall and phenotype-based vasodilator utilizations showed significant declines, with overall usage dropping from 61.4% in 2013 to 48.6% in 2021 (Ptrend<0.001). Conversely, no temporal changes were observed in overall inotrope/vasopressor utilization from 24.6% in 2013 to 25.8% in 2021 or the proportion of phenotype-based utilization. Notably, there was considerable variability in phenotype-based drug utilization among hospitals, with a median ranging from 48.3% to 77.8%. In multivariable-adjusted models, a higher number of board-certified cardiologists were significantly associated with lower rates of phenotype-based vasodilator utilization and reduced inappropriate inotrope/vasopressor utilization, while tertiary care hospitals were linked to more appropriate inotrope/vasopressor utilization. Substantial variability existed among hospitals in phenotype-based drug utilization of vasoactive agents for patients with acute decompensated heart failure, highlighting the need for standardized treatment protocols. URL: https://www.umin.ac.jp/ctr/index.htm; Unique identifier: UMIN000013128.

Antimicrobial Drug Utilization and Resistance Trends in Septicemia Patients: A Comprehensive Study at a Tertiary Care Hospital

Background: Septicemia is still among the leading causes of morbidity and mortality worldwide, especially among patients in the intensive care unit. The right use of antimicrobial agents is central to the successful management of septicemia, but increasing incidences of antimicrobial resistance are a big challenge. Objective: This study aimed to quantify the antimicrobial usage, resistant organisms, and clinical performance in septicemia patients in a tertiary healthcare facility in Bangladesh. Methods: A prospective observational study was done in the Department of Medicine, Community Based Medical College Hospital, over a period of 16 months. One hundred and ten participants with septicemia and admitted to the ICU were recruited. Demographic data, antimicrobial consumption, microbiological results, and clinical outcomes were gathered and examined. Results: Most of the patients were male (54.5%) and within the age group of 31–40 years. Cephalosporins were the most common first-line antimicrobials (13.3%), while macrolides (12.3%) and carbapenems (11.7%) were at the second and third rank, respectively. There were frequent alterations in antimicrobial therapy; in 28 percent of cases, ceftriaxone was replaced by levofloxacin. Patients with resistant infections had the advantage of a longer hospital and ICU stay of at least 1 week (p&lt;0.01). 16% in patients with resistant infections. Conclusion: The topics discussed in this study include the issues arising from septicemia management due to antimicrobial resistance, the requirement of broad-spectrum empiric therapy, often changing antimicrobial regimens, and overall poor outcomes for such resistant infections. Overall, the present results highlight the need for strict adherence to principles of antimicrobial stewardship, local resistance pattern monitoring, and the creation of novel therapeutic interventions. Additional multi-centered trials to determine strategies against septicemia and AMR in limited resource .........

Leveraging Machine Learning and Patient Reviews for Developing a Drug Recommendation System to Reduce Medical Errors

Background In the rapidly evolving pharmaceutical industry, drug efficacy and safety stand as critical concerns. The vast accumulation of data, including customer feedback, drug popularity, and usage details, offers a rich resource for improving healthcare outcomes. Aims The primary aim of this study is to harness machine learning and Natural Language Processing (NLP) techniques to sift through extensive pharmaceutical data, identifying the most effective drugs for various conditions and uncovering patterns that could guide better decision-making in drug efficacy and safety. Objective This research seeks to construct a sophisticated model capable of analyzing diverse data points to pinpoint the most efficacious drugs for specific health conditions, thereby providing pharmaceutical companies with data-driven insights to optimize drug safety and effectiveness. Methods Employing a blend of Natural Language Processing (NLP) and machine learning strategies, the study analyzes a comprehensive dataset featuring customer reviews, drug popularity metrics, usage information, and other relevant data collected over an extended period. This methodological approach aims to reveal latent trends and patterns that are crucial for assessing drug performance. Results The developed model adeptly identifies leading medications for various conditions, elucidating efficacy and safety profiles derived from patient reviews and drug utilization trends. These findings furnish pharmaceutical companies with actionable intelligence for enhancing drug development and patient care strategies. Conclusion The integration of machine learning and NLP for the analysis of vast drug-related datasets presents a powerful method for advancing drug efficacy and safety. The insights yielded by the proposed model significantly empower the decision-making processes of the pharmaceutical industry, ultimately fostering improved health outcomes for patients.

Trends in Pediatric Attention-Deficit Hyperactive Disorder Diagnoses and Prescription Utilization: 2016 to 2019.

Attention-deficit hyperactive disorder (ADHD) is one of the most common psychiatric disorders among children, with estimated prevalence of 7% to 15% worldwide. The aim of this analysis was to update and summarize trends in diagnosis, demographics, and drug utilization of pediatric patients with ADHD. We used the Agency for Health care Research and Quality Medical Expenditure Panel Survey (MEPS), a survey of US individuals, families, their medical providers, and employers, using datasets from 2016 to 2019. The data sources from the MEPS database included the full-year consolidated files, medical conditions files, prescribed-medicines files, and condition-event link files for each year. We summarized trends in the proportion of children, ages 17 years and younger, with a diagnosis of ADHD, demographic information and a prescription for medication known to treat ADHD. In addition, we further stratified ADHD medication use by stimulant/nonstimulant categories. There was a 1.6% and 4.7% absolute increase in children with an ADHD diagnosis and those prescribed ADHD medications, respectively, from 2016 to 2019. Most of these children were male, non-Hispanic, and on public insurance. Of the children prescribed an ADHD medication and concomitant behavioral medications, stimulants-only use was the highest (60%-67%), followed by stimulants/nonstimulants (13%-15%), stimulant/antidepressants (6%-9%), and nonstimulants only (5%-9%). The proportion of patients with ADHD in the high-income and near-poor categories increased by 4% from 2016 to 2019. Diagnosis of ADHD among children is trending upward in the United States. Central nervous system stimulants, especially methylphenidate formulations, are the most prescribed ADHD medications for children 17 years and younger.

Use of lipid-lowering drugs in restricted health access settings: Results from the Trends in Drug Utilization During COVID-19 Pandemic in Turkey (PANDUTI-TR) study

BackgroundCOVID-19 restrictions prompted changes in chronic disease management and lifestyle modifications, potentially altering cardiometabolic indicators and lipid-lowering pharmacotherapy patterns. We aimed to assess lipid-lowering drug (LLD) utilization trends during COVID-19 restrictions. MethodsWe obtained nationwide outpatient drug sales and prescribing data for 01.03.2018–31.12.2022 from IQVIA™ Turkey. We evaluated average monthly LLD consumption, their costs, and quarterly prescribing levels in three periods: “before restrictions” (BfR, 01.03.2018–31.03.2020), “during restrictions” (DuR, 01.04.2020–31.03.2022), and “after restrictions” (AfR, 01.04.2022–31.12.2022). Drug utilization was measured via “defined daily dose/1000 inhabitants/day” (DID) metric. ResultsLLD utilization increased from 25.4 ± 3.1 DID in BfR to 36.2 ± 6.8 DID in DuR (p < 0.001), and to 42.6 ± 5.3 DID in AfR (p < 0.001 vs. BfR). Statin consumption significantly rose from 22.0 ± 3.0 DID in BfR to 31.6 ± 6.3 DID in DuR (p < 0.001), and further to 37.6 ± 4.7 DID in AfR (p < 0.01 vs. DuR). High-intensity statin consumption elevated by 115.9% in AfR compared to baseline (p < 0.001). Prescribing of LLDs decreased from 12.5 ± 0.6 DID in BfR to 7.2 ± 1.2 DID in DuR (p < 0.001), later reached 13.6 ± 3.8 DID in AfR (p < 0.001 vs. DuR), with prescribing for ongoing users following similar trend. Expenditure on LLDs increased from €8.4 m ± 0.9 m in BfR to €11.4 m ± 2.0 m in DuR (p < 0.001) and to €12.8 m ± 1.9 m in AfR (p < 0.001 vs. BfR). ConclusionsThis study revealed a surge in consumption of LLDs in Turkey following the onset of the COVID-19 pandemic. This rise might be related to practices facilitating drug access, in addition to potentially greater adherence, or the necessity for more intense pharmacotherapy due to elevated cardiovascular risk.

Impact of supply chain disruptions and drug shortages on drug utilization: A scoping review protocol.

This proposed scoping review aims to examine studies assessing the impact of drug shortages on population-level drug utilization trends. The objectives of this review are to a) assess which drugs have been studied and describe associated drug characteristics, b) determine jurisdictions and healthcare settings that have conducted these studies, and c) describe how changes in drug use and the extent of shortage impacts are reported in literature. Drug shortages continue to impair drug access and delivery of quality care across the world. However, the impact of drug supply disruptions on availability and drug use are understudied in current literature. This proposed scoping review will identify this gap and inform future research initiatives aimed at determining the real-world impacts of drug shortages. Published and unpublished observational studies reporting on the effects of drug supply chain disruptions (shortages, discontinuations, and safety-based withdrawals) on consequent utilization trends faced by pharmaceutical products (i.e. prescription drugs, over-the-counter drugs, vaccines, therapy products, pharmaceutical solutions). Literature reviews, meta-analyses, randomized control trials, case series, case reports, and opinion pieces will be excluded. The search strategy will combine two key search concepts: drug shortages and drug utilization. The search will be conducted in MEDLINE and EMBASE. This will be followed by an extensive grey literature search in grey literature databases, targeted websites and Google. Furthermore, reference lists of included articles will be searched. Articles will be independently screened, selected and extracted by two reviewers. Data will be descriptively analyzed and presented in tables. Review registration number: Open Science Framework, https://osf.io/2p6e5.

Trends in antihypertensive drug utilization in British Columbia, 2004-2019: a descriptive study.

Clinical guidelines for hypertension were updated with lower blood pressure targets following new studies in 2015; the real-world impact of these changes on antihypertensive drug use is unknown. We aimed to describe trends in antihypertensive drug utilization from 2004 to 2019 in British Columbia. We conducted a longitudinal study to describe the annual prevalence and incidence rate of use of 5 antihypertensive drug classes (thiazides, angiotensin-converting enzyme [ACE] inhibitors, angiotensin II receptor blockers [ARBs], calcium channel blockers and β-blockers) among BC residents aged 30-75 years. We also conducted a cohort study to compare the risk of discontinuation and switch or add-on therapy between incident users of the above drug classes. We used linkable administrative health databases from BC. We performed a Fine-Gray competing risk analysis to estimate subhazard ratios. Among BC residents aged 30-75 years (population: 2 376 282 [2004] to 3 014 273 [2019]), the incidence rate of antihypertensive drug use decreased from 23.7 per 1000 person-years in 2004 to 18.3 per 1000 person-years in 2014, and subsequently increased to 22.6 per 1000 person-years in 2019. The incidence rate of thiazide use decreased from 8.9 per 1000 person-years in 2004 to 3.2 per 1000 person-years in 2019, and incidence rates for the other drug classes increased. Incident users receiving thiazide monotherapy had an increased risk of discontinuing any antihypertensive treatment compared with ACE inhibitor monotherapy (subhazard ratio 0.96, 95% confidence interval [CI] 0.95-0.97), ARB monotherapy (subhazard ratio 0.84, 95% CI 0.81-0.87) and thiazide combination with ACE inhibitor or ARB (subhazard ratio 0.86, 95% CI 0.84-0.88), and had the highest risk of switching or adding on. First-line use of thiazides continued to decrease despite a marked increase in incident antihypertensive therapy following updated guidelines; incident users receiving ARB monotherapy were least likely to discontinue, and incident users receiving thiazide monotherapy were more likely to switch or add on than users of other initial monotherapy or combination. Further research is needed on the factors influencing treatment decisions to understand the differences in trends and patterns of antihypertensive drug use.

Assessing drug utilization and drug–drug interactions in the management of epilepsy, Alzheimer’s, Parkinson’s disease and migraine

Abstract Background Neurological disorders (ND) affect the structure and function of the central nervous system, including Alzheimer’s and Parkinson’s diseases, epilepsy, migraine and stroke. ND has major symptoms ranging from mild to severe memory problems and physical disabilities. The present study investigated central nervous system (CNS) drug utilization trends, drug–drug interaction and morbidity patterns in ND. Methods A prospective study was carried out at a multi-specialty hospital, including neurology outpatient cases, in 2016. A study was ethically approved by the institutional ethics committee (IEC) for human research, and data were collected from patients’ case records. The prescribing trend was assessed by World Health Organization (WHO) core prescribing indicators. The International Classification of Diseases (ICD) 10 was used to assess the morbidity pattern. Drug–drug interactions were analysed by a multidrug interaction checker. Results We discovered that 53.57% and 46.42% of the 280 neurology cases were female and male, respectively. Here, we showed that epilepsy was the most commonly diagnosed (31.07%) condition, followed by migraine (30.35%), Parkinsonism (Pn) (13.21%), Alzheimer’s and dementia (AD) (10.71%) and myasthenia gravis (7.14%). The most commonly used CNS drugs were sodium valproates. Donepezil, fluoxatin and levodopa–carbidopa. In this study, 80% of drugs were prescribed with the most common category being antiepileptics; 16.77% and 23.21% of prescriptions observed potential drug–drug interactions. Conclusions The treatment priority for epilepsy was sodium valproate, which had a high prescription rate. For AD, donepezil was given priority, while in PN, levodopa–carbidopa was prescribed most often. In significant drug–drug interactions (DDI), pharmacodynamic mechanisms were very common, while in minor DDI, pharmacokinetic mechanisms were observed.

Spending, Utilization, and Price Trends for Immune Checkpoint Inhibitors in US Medicaid Programs: An Empirical Analysis from 2011 to 2021

Immune checkpoint inhibitors (ICIs) have become a cornerstone in cancer treatment. With high treatment costs and an increasing number of young and low-income patients with cancer, there is a need to determine the current spending and utilization of ICIs in a real-world population. The objective of this study was to outline the drug spending, utilization, and price trends of ICIs for US Medicaid programs from 2011 to 2021. A retrospective descriptive analysis was conducted using the Medicaid State Drug Utilization pharmacy summary files managed by the Centers for Medicare and Medicaid Services. Six ICIs for this study include ipilimumab, pembrolizumab, nivolumab, atezolizumab, avelumab, and cemiplimab. Yearly reimbursement and prescription numbers were calculated for six ICIs billed through Medicaid between 2011 and 2021. The average spending per prescription was calculated as a proxy for drug prices. Overall spending and utilization on ICIs have risen exponentially over the past decade. Between 2011 and 2021, expenditures increased from $2.8 million to $4.1 billion. Utilization increased from 94 prescriptions to 462,049 prescriptions in 2021 with six ICIs. The average spending per prescription, or average drug price, decreased 70%, from $29,795.88 in 2011 to $8914.69 in 2021. Spending on and utilization of ICIs have increased dramatically over the past decade. These findings shed new light on the impact of ICIs on state Medicaid programs and may provide insight into potential cost drivers that need to be addressed through policy.

Study of Drug Utilization Pattern during Second Wave of Covid-19 in a Tertiary Care Centre: A Retrospective Cross Sectional Study

Background: To study the drug utilization trends among patients with COVID-19 disease during the second wave in a tertiary care hospital. Methods: A retrospective cross-sectional study was conducted in patients admitted in COVID-19 wards during second wave of SARS – COVID-19 pandemic from 1st March 2021 to 30th June 2021. A total of 300 prescriptions were analysed. Assessment of prescription patterns were done as per the WHO-The International Network for Rational Use of Drugs (INRUD)drug use indicators. Results: A total of 3106 drugs were analysed.The average number of drugs prescribed was 11±5.1. The most frequent prescription was that of analgesic and antipyretic drug Paracetamol (95.26%) followed by vitamin C (94.74%) and multivitamins(87.89%) . Nearly all patients in this study received antibacterials, 68% received antivirals. Antibacterials commonly used were cephalosporins, amoxicillin- clavulanic acid combination and pipercillin –tazobactam combination. Antiviral drug Remdesivir was also used extensively in our study (54.21%). Other class of drugs which were commonly prescribed to more patients were Dalteparin (73.16%) and corticosteroids like methyl prednisolone (52.63%) and dexamethasone (51.05%). 35.68% of the drugs were prescribed with generic name .45.43% of the drugs were injectables . 2.96% of the drugs were prescribed as fixed dose combinations. Conclusion: In summary, the drug utilization for hospitalized patients with COVID-19 was diverse but generally complied with the ongoing guidelines. The drug were mostly prescribed from WHO essential drug list and percentage of fixed dose combination prescription was low. However not prescribing the drugs by generic name and large encounters of injectable was matter of concern. To get a better glimpse of drug utilization a more extensive study needs to be undertaken.

Trends in brand and generic drug utilization for dermatology providers from 2013-2019.

Prescription drug costs have risen considerably in the United States and are projected to reach $560 billion by 2028. To evaluate brand and generic drug utilization and cost proportions within Medicare Part D. Prescription data for dermatology providers were obtained from the Centers for Medicare and Medicaid Services 2013-2019 Medicare Part D Prescribers by Provider datasets. Percentage of brand vs. generic drug claims and costs and cumulative annual growth rates (CAGRs) were calculated. For the most recent year of data (2019), we conducted additional sub-analyses for calculated percentages by prescriber variables. The proportion of brand drug claims increased from 7.4% (in 2013) to 10.5% (2019) with a CAGR of 8.66%. In comparison, generic drug claims increased at a lower rate (CAGR 4.47%). The percentage of brand drug costs increased from 27.5% (in 2013) to 75.1% (2019). Inability to assess and generalize data for prescription patterns under non-Medicare plans. Our study demonstrates a disproportionate rise in dermatologic brand drug claims and a substantial increase in costs associated with brand drugs. Brand-name drugs are associated with higher out-of-pocket expenses for patients, which can lead to decreased access and adherence to treatment.

Trends in the utilization of psychotropic medications in China from 2018 to 2021

Background: Monitoring psychotropic medicine consumption trends can provide information on the extent of pharmacological interventions for mental disorders and availability of psychotropic medicines. Objectives: This study aimed to illustrate the trends in psychotropic drug utilization in China’s hospitals. Methods: We retrospectively analyzed the aggregated monthly psychotropic procurement records of 1009 hospitals from 31 provinces in China from January 2018 to September 2021. Total psychotropic medicine consumption included the sales of antipsychotics, antidepressants, anxiolytics, mood stabilizers, and sedatives or hypnotics. Information, including generic name, procurement amount, dosage form, strength, purchase time, and geographical data, was collected. Population-weighted psychotropic utilization was expressed in defined daily dose per 1000 inhabitants per day (DDD/1000/day). Results: Psychotropic medicine sales increased from 4.5 DDD/1000/day in Q1 2018 to 6.4 DDD/1000/day in Q3 2021; total utilization in China’s hospitals increased by 42.2%. The use of each class of psychotropics showed a gradually increasing trend. Antidepressants were the most consumed psychotropics, accounting for 48.4% of the total psychotropic utilization (3.1/6.4 DDD/1000/day), followed by sedatives or hypnotics (31.3%; 2.0/6.4 DDD/1000/day) and antipsychotics (15.6%; 1.0/6.7 DDD/1000/day). Among all sub-classes of psychotropics, a most significant growth in DDD per 1000 inhabitants per day was seen for selective serotonin reuptake inhibitors (1.2–1.9 DDD/1000/day), whereas the consumption of typical antipsychotics (from 0.1 to 0.09 DDD/1000/day) and tricyclic antidepressants (from 0.05 to 0.03 DDD/1000/day) decreased during the study period. Psychotropic utilization substantially increased between Q1 2018 and Q3 2021 in regions with different economic levels. In Q3 2021, total psychotropic utilization in secondary and tertiary hospitals was 9.4 DDD/1000/day and 6.0 DDD/1000/day, respectively. Sedatives or hypnotics in secondary hospitals accounted for the largest proportion of utilized psychotropics (43.6%; 4.1/9.4 DDD/1000/day), whereas antidepressants were the most commonly used psychotropic in tertiary hospitals (50.0%, 3.0/6.0 DDD/1000/day). Conclusion: This study showed that despite increases in psychotropic medication use, the consumption of medicines is still much lower than in other countries and regions internationally. With reference to the estimated prevalence of corresponding mental disorders, our study illustrates that a large treatment gap for mental health problems exists in China. In addition, the wide use of psychotropics with weak clinical evidence raises serious concerns regarding rational use. Greater efforts are needed to increase the availability of psychotropic medicines and to facilitate proper psychotropic use.

Trends in Medicare oral anticancer drug utilization among relapsed and refractory chronic myeloid leukemia patients.

e19058 Background: The treatment landscape for patients with relapsed and refractory (RR) chronic myeloid leukemia (CML) has changed significantly in recent years, with the introduction of targeted oral anticancer therapies. Current guidelines from the National Cancer Comprehensive Network (NCCN) recommend tyrosine-kinase inhibitors (TKIs) for second line and subsequent therapy. Recent real-world data evaluating treatment patterns in RR CML is limited. Study objective was to evaluate treatment patterns and trends in utilization of oral anticancer agents among Medicare beneficiaries diagnosed with RR CML, from 2017-2019. Methods: Retrospective study using Medicare Part D Prescription Drug Event Files, which contain records on prescription drug fills among Medicare beneficiaries enrolled in Fee-for-Service and Medicare Advantage plans. Beneficiaries diagnosed with RR CML (C9212 ICD-10) and prescribed oral anti-cancer therapy (Bosutinib, Dasatanib, Nilotinib, Ponatinib or Imatinib Mesylate) were identified and followed for at least 12 months, from index diagnosis until end of study period (December 31, 2019) or death. Trends in utilization by oral therapy, by number of beneficiary utilizers and prescription drug claims, were evaluated from 2017 to 2019. Results: Overall, 327 Medicare beneficiaries with a diagnosis of RR MM were prescribed an oral TKI therapy (Bosutinib, Dasatanib, Nilotinib, Ponatinib or Imatinib Mesylate) throughout the study period (2017-2019). The number of beneficiaries prescribed at least 1 oral therapy increased between 2017 and 2019, from 154 to 212 (Table). Total utilization also increased: from 210 prescription drug claims in 2017 to 296 in 2019. Throughout the study period, Imatinib Mesylate had the largest market share among all oral therapies, however the share decreased over time (from 35.7% in 2017 to 30.7% in 2019). Nilotinib had the largest gain in market share during this period, from 15.7% to 20.9%. Conclusions: Study findings suggest utilization of oral therapies are increasing over time, and shifting from Imatinib Mesylate to newer therapeutic agents. Given the high costs for these novel therapies, future research should examine trends in patient out-of-pocket spending, as well as factors impacting patient adherence.[Table: see text]

Drug utilization study in patients affected with COVID-19 in a dedicated COVID hospital

Background: There exists a treatment dilemma regarding the optimal and effective use of therapeutic drugs (hydroxychloroquine/chloroquine/azithromycin) for COVID-19. Furthermore, with changing guidelines, the data on drug utilization patterns across India are limited. Hence, this study was conducted to assess the prescription pattern and drug utilization trends in COVID-19 patients with the aim to study the drug utilization pattern in patients affected with COVID-19 in a dedicated COVID-19 hospital. Aims and Objectives: The objectives of the study are as follows: (1) To study drug utilization patterns according to the severity of the disease. (2) To study the prevalence of adverse drug reactions (ADRs). Materials and Methods: Data were collected retrospectively from 100 medical records of patients ≥18 years irrespective of sex admitted in the COVID ward and ICU of a dedicated COVID hospital from May to August 2020. Pregnant and lactating women were excluded from the study. ADRs reported were also analyzed. Results: About 71% were mild in this study, 18% were moderate, and 11% were severe COVID-19 patients. Overall, the most common drugs prescribed were multivitamins, followed by pantoprazole, paracetamol, and azithromycin. Hydroxychloroquine was prescribed in 22%, favipiravir in 7%, and remdesivir in 3% of cases. The majority of moderate COVID patients received injectables piperacillin-tazobactam, methylprednisolone, and enoxaparin. The mean number of medications, duration of admission, and number of days on oxygen were higher and significant in moderate compared to mild and severe COVID patients. Overall, ADRs were encountered in 9% of cases. Conclusion: The prescribed pattern of drugs was by the national standard guidelines. Multivitamins, followed by pantoprazole, paracetamol, and azithromycin dominated the prescription pattern. Polypharmacy was encountered, which needs to be addressed for the rational use of drugs.

Trends in antidiabetic drug utilization in Type 2 diabetes patients in a diabetes clinic of a tertiary care teaching hospital in India

Trends in antidiabetic drug utilization in Type 2 diabetes patients in a diabetes clinic of a tertiary care teaching hospital in India

POSC403 Biologic, Biosimilar and Specialty Drug Utilization Trends Among US Employers

POSC403 Biologic, Biosimilar and Specialty Drug Utilization Trends Among US Employers

Choppy waters: The importance of accounting for shifting drug utilization during the COVID-19 pandemic in future observational drug-related studies.

The 2019 novel Coronavirus (COVID-19) pandemic caused a large shift in the delivery of healthcare globally, including prescription drugs. Media reports of drug stockpiling, anecdotal reports of an uptick in commonly used medications and off-label use of medications to treat COVID-19, have led to rapidly changing drug utilization trends.1 We have observed shifting drug utilization trends in a number of our ongoing projects globally. These shifting drug utilization trends should be of consideration for anyone conducting future observational drug-related studies - we write this Reflective Piece, Hot Topic as a word of caution to our colleagues.

Drug Utilization Study in Ophthalmology Outpatient Department of a Tertiary Care Hospital in West Africa

The World Health Organization (WHO) addressed drug utilization as the marketing, distribution, prescription and use of drugs in a society, considering its consequences, either medical, social, (and) or economic. The increasing importance of drug utilization studies as a valuable investigative resource in pharmacoepidemiology has bridged it with other health related areas, such as public health. Surveillance of drug use by the doctors within the institution as well as in the community is assuming an increasingly key role in therapeutics. This was a cross-sectional study of prescription pattern and drug utilization trends at the Lions International Eye Centre (LIEC) of the Korle Bu Teaching Hospital and adherence to the standard prescription form at the Eye Centre. Prescriptions that were presented to the LIEC pharmacy unit within the period from October 2015 to March 2016 were captured and reviewed. The total number of drugs in the 588 prescriptions was 1265. The average number of drugs per prescription was 2.1. Drug dosage, route of administration, frequency, and duration of treatment record were mentioned in 95.01% (1202/1265), 97% (1227/1265), 98.46% (1240/1265) 96.05% (1215/1265) of the prescriptions respectively. Anti-glaucoma medicines were the most prescribed 21.8% (276/1265), Prescribing by generic name slightly dominated with 51.1% (645/1265) of the total number of drugs prescribed. Use of Ophthalmic antibiotics alone and the use of ophthalmic antibiotics in combination with other medicines were 13.5% (171/1265) and 11.9% (142/1265) respectively.: The findings of this study revealed that the drug utilization pattern was not in line with the recommended standard values of WHO prescribing indicators even though the level of compliance to the requirements on the standard prescription form of the hospital for drug prescribers was remarkably high. The availability of key medicines should be improved whilst generic prescribing from EDL should also be encouraged.

Time trends in pharmacological treatment of major depressive disorder: Results from the AMSP Pharmacovigilance Program from 2001–2017

Background: Currently available data on the prescription practice among patients with major depressive disorder (MDD) reflect the outpatient setting. This is the first study to provide information on time trends of psychotropic drug utilization in psychiatric inpatients.Method: Data stems from German-speaking psychiatric hospitals collected by the program “Drug Safety in Psychiatry” (Arzneimittelsicherheit in der Psychiatrie, AMSP) between 2001 and 2017. 44,418 psychiatric inpatients with MDD were included. Time trends in drug utilization were analyzed by comparing the first (2001–2003) and last time point (2015–2017) using risk ratios (RR).Results: Antidepressant drugs (ADD) were the most used psychotropic drug class with utilization decreasing slightly from 2001–2003 (89.7%) to 2015–2017 (85.5%). Use of tricyclic ADDs showed the greatest decline (RR 0.35), while use of selective serotonin-noradrenaline reuptake inhibitors (RR 1.72) and “other ADDs” increased the most. Use of antipsychotic drugs (APD), especially second-generation antipsychotic drugs (RR 1.46), increased. Use of tranquilizing (RR 0.71) and hypnotic drugs (RR 0.43) both decreased. Most patients were treated with more than one psychotropic drug, most often ADD + APD, which was utilized more often in 2015–2017 (51.1%) than in 2001–2003 (45.1%; RR 1.13). Combination of two ADDs increased from 2001–2003 (24.5%) to 2015–2017 (33.0%; RR 1.35).Limitations: The cross-sectional design does not allow conclusions to be drawn about causal relationship of findings. Further, only certain clinical and sociodemographic data was available.Conclusion: Treatment of MDD has shown significant changes from 2001 to 2017.

Drug Utilization Study of Respiratory Tract Infection

In the present study, we have recorded the percentage of prescribing prevalence for different respiratory drugs and antibiotics and DDDs/1000inhabitants/day for different antibiotics to recognize the drug utilization trends in respiratory tract infections. In the present study, among the upper respiratory infection cases, 89.60% of the patients received antibiotics and culture was done in only 4.62% of patients. Among the lower respiratory infection cases all the patients were prescribed antibiotic therapy, culture was done in 39.58% of patients, and 55.26% was sterile. Pneumonia was found more in the age group of 41 to 70 whereas Nonspecific URTI and Sinusitis in the age group of 17 to 30. The sex distribution of the patients showed that the female constituted of 59.38% of the patients and male constituted of 40.56% of the patients. The upper respiratory tract infection constituted of 69.47% of patients and lower respiratory tract infection constituted of 31.16% of patients.