Frequency Of Drug Prescription Research Articles

Prescribing patterns in breast cancer survivors: A Korean National Health Insurance Service cohort study.

Breast cancer survivors often manifest comorbidities that require medication management. This study aimed to investigate the prescription patterns of drugs prescribed frequently among breast cancer survivors and to provide data to monitor adverse effects using other covariates in these patients. We analyzed a Korean national sample cohort database. The diagnosis of breast cancer, survival, survival duration, and frequency of drug prescription were first defined and extracted. We then analyzed the frequency of drug prescription in breast cancer by survival duration. Factors associated with drug prescribing patterns were analyzed using logistic regression analysis. Among 2,410 breast cancer survivors, anti-hormonal agents, gastrointestinal drugs, calcium, and anxiolytics were most frequently prescribed. Gastrointestinal disturbance and depression are most commonly observed among breast cancer survivors. Survivors who were 3 to < 5 years post treatment were frequently prescribed calcium. In addition to gastrointestinal drugs, anxiolytics were frequently prescribed among survivors manifesting comorbidities. In addition to anti-hormone agents, which were frequently prescribed to breast cancer patients, gastrointestinal drugs were the second most frequently prescribed, and anxiolytics were often co-prescribed. Calcium was also frequently co-prescribed in patients requiring anti-depressants. In the Korean National Cohort, gastrointestinal drugs, calcium, and anxiolytics were frequently prescribed to older patients, suggesting that older patients diagnosed with cancer experience a wide array of toxicities requiring supportive care.

Management of migraine in the emergency department: Findings from the 2010-2017 National Hospital Ambulatory Medical Care Surveys.

The study objective was to describe trends in the medical management of migraine in the emergency department (ED) using the 2010-2017 National Hospital Ambulatory Medical Care Survey (NHAMCS) datasets. Using the 2010-2017 NHAMCS datasets, we analyzed visits with a discharge diagnosis of migraine. Drug prescription frequencies between years were compared with the Rao-Scott chi-squared test. Adjusted odds ratios of opioid administration from 2010 to 2017 were calculated using weighted multivariable logistic regression with sex, age, race/ethnicity, pain-score, primary expected source of payment, and year as predictor variables. Our analysis captured 1846 ED visits with a diagnosis of migraine from 2010 to 2017, representing a weighted average of 1.2 million US ED visits per year. Parenteral opioids were prescribed in 49% (95% CI: 40, 58) of visits in 2010 and 28% (95% CI: 15, 45) of visits in 2017 (p=0.03). From 2010 to 2017, there was a 10% yearly decrease in opioid prescriptions. Metoclopramide and ketorolac were prescribed more frequently in years 2015 through 2017 than in 2010. Increased opioid administration was associated with female sex, older age, white race, higher pain score, and having Medicare or private insurance as the primary expected source of payment for all years. Opioid administration for migraine in EDs across the US declined 10% annually between 2010 and 2017, demonstrating improved adherence to migraine guidelines recommending against opioids. We identified several factors associated with opioid administration for migraine, identifying groups at higher risk for unnecessary opioids in the ED setting.

The trends of assisted reproductive technologies and cost for ovarian stimulation protocols in Ukraine

The prevalence of infertility has risen 2.9 times in recent years in Ukraine. The use of assisted reproductive technologies (ART) is needed. The State program for infertility treatment by budget funds was approved in Ukraine since 2004. However, funding for this program is enough only for 500–600 cycles per year, but ART centers conducted more than 27,000 cycles in 2018. This means that many women have to pay out-of-pockets. Our research has shown that between 2000 and 2018, the number of ART clinics and the number of cycles, pregnancies, and children born increased significantly in Ukraine. The rate of ART cycles per 1 million population in Ukraine has increased from 226.9 to 655.3, but it is lower than the WHO recommended rate 800–1000 cycles per 1 million population. Changes in the structure of ART cycles for 2000–2018, the increase of ICSI, and egg donation cycles are shown. It requires an adequate supply by hormonal drugs for ovarian stimulation in ART centers. Since 2004 Ministry of Health of Ukraine annually approved the list of medicines for State program of ART. Only 8 drugs were purchased by the state funds, which amounted for USD 227 438 in 2017, 2018. A retrospective analysis of drug prescriptions in short and long stimulation protocols was performed. The frequency of drug prescriptions according to the ATC-classification based on medical records was determined, all prescriptions were accordance with the requirements of ART treatment standards in Ukraine. The costs of the three hormonal stimulation schemes, which were the most prescribing in ART center, were calculated. It was found that costs for hormonal schemes increased by 22–54% during 2015–2020, it significantly reduces the availability and affordability of ART for the population in Ukraine.

The results of VEN/frequency analysis of pharmacotherapy of patients with chronic gastroduodenitis in a healthcare institution of Kharkiv

Chronic gastroduodenitis (CGD) refers to diseases that have a medical and social importance due to the wide prevalence among the population, a tendency to relapse, the risk of complications, a decrease in the patient’s quality of life, the high overall cost of the disease.Aim. To assess the quality of pharmacotherapy: the frequency of drug prescriptions for patients with CGD in the gastroenterology department of one of the healthcare institutions in Kharkiv and their correspondence with the clinical protocols of medical care and the State Formulary of Ukraine (SFU).Materials and methods. The assessment of the quality of pharmacotherapy of patients with CGD was performed using of supplementary clinical and economic methods such as frequency and “formal” VEN-analysis.Results. When using the “formal” VEN-analysis it was determined that the majority of the medicines prescribed were recommended by clinical protocols for pharmacotherapy of the main (CGD) and concomitant diseases registered in the patients under research, and present in the SFU (93.75 % and 80.00 %, respectively). Based on the results of frequency analysis it was found that the medicines presented in these documents were prescribed in most cases (98.81 % and 89.63 %, respectively).Conclusions. The main directions of pharmacotherapy of patients with CGD in the gastroenterology department of one of the healthcare institutions in Kharkiv correspond to the clinical protocols of medical care for patients with CGD and concomitant diseases at baseline. The medicines recommended by the clinical protocols and present in the SFU constitute the vast majority of drug prescriptions. Therefore, in general, pharmacotherapy of patients with CGD in this healthcare institution in Kharkiv can be considered as rational from the clinical point of view.

CURRENT ECOMOMICAL, SOCIAL ASPECTS OF HEALTH TECHNOLOGIES FOR PRETERM BIRTH AND REAL WORLD DATA OF DRUG PRESCRIPTIONS IN UKRAINE

Поліпшення якості життя, здоров'я вагітних жінок та лікування передчасних пологів є основними цілями директив ВООЗ. Україна займає 72 місце в рейтингу за рівнем забезпечення материнства в світі.Нами вивчені у порівняльному плані рекомендації ВООЗ, 2015 міжнародні рекомендації, накази МОЗ України щодо лікування передчасних пологів (ПП) та виявлено певні відмінності, що вимагає оновлення вітчизняних протоколів.Ми проаналізували реальні дані частоти призначень лікарських засобів при ПР з використанням АВС^Е^аналізу на основі 102 історій хвороб вагітних жінок з діагнозом відповідно до МКХ-10 - 047.0. Встановлено, що для лікування загрози ПП призначалися 75 торгових назв (46 МНН лікарських засобів та 2 БАД). Сумарно було 689 призначень ліків, що в середньому складає 6,75 препарата на одну вагітну жінку, що свідчить про поліпрагмазію. Виявлено, що в групі А найбільш часто призначаються препарати 7 МНН (14,58 % від загального обсягу) і основним лікарським засобом є натрію хлорид, що свідчить про недостатньо раціональне використання фінансових коштів пацієнтів.Встановлено, що сумарно витрати на призначені ЛЗ при ПР становили 75354,3 грн, а витрати на фармакотерапії 1 пацієнтки були в середньому 740,2 грн.Нами проаналізовані доказові дані про призначення прогестеронів для лікування ПР. Встановлено, що найбільш ефективним для лікування ПП за даними доказової фармації є прогестерон у лікарській формі для вагінального прийому для жінок з короткою шийкою матки, а дигістростерон - при застосуванні допоміжних репродуктивних технологійДоцільною є оптимізація фармацевтичної допомоги вагітним при ПР за даними доказової фармації та призначення економічно ефективної фармакотерапії для раціоналізації витрат пацієнтів.

PHP21 - Drug Utilization Study of Antibiotics in A Secondary Care Referral Hospital

The main aim is to Study the appropriateness and quantify the utilization of antibiotics. A Cross Sectional study was conducted in a secondary care referral hospital for a period of three months using the prescriptions of the patients suffering with the various infections Altogether 150 patients, (67.15%) males and 236 (32.85%) females were enrolled. Among these, highest rate of drug prescription was observed for patients aged between 40 to 60 years, which consist of 85(56.6%) patients . Highest rate of antimicrobial prescription was observed for patients of respiratory and urinary tract infections .Highest frequency of drug prescription was observed for Azithromycin which consist of 30.35% which was followed by Amoxicillin 18.12%, Cifixime (6.52%), Doxycycline (24.13%),ceftriaxone(12.3%) , ciprofloxacin (8.58%), Overall 76.84% of the patients were treated with a combination therapy of antibiotics, But if antibiotics are not used rationally then there will be increase chances of resistance of bacteria as also as increase the total cost of treatment and adverse reactions. Drug utilization studies are used as powerful tools to ascertain the role of drugs in the management of various diseases. There is a need of patient education and counseling on use of antimicrobial drugs (AMDs) by the clinical pharmacist.

Frequency of potential interactions between drugs in medical prescriptions in a city in southern Brazil

Drug interactions form part of current clinical practice and they affect between 3 and 5% of polypharmacy patients. The aim of this study was to identify the frequency of potential drug-drug interactions in prescriptions for adult and elderly patients. TYPE OF STUDY AND SETTING: Cross-sectional pharmacoepidemiological survey in the Parque Verde housing project, municipality of Cascavel, Paraná, Brazil, between December 2006 and February 2007. Stratified cluster sampling, proportional to the total number of homes in the housing project, was used. The sample consisted of 95 homes and 96 male or female patients aged 19 or over, with medical prescriptions for at least two pharmaceutical drugs. Interactions were identified using DrugDigest, Medscape and Micromedex softwares. Most of the patients were female (69.8%), married (59.4%) and in the age group of 60 years or over (56.3%), with an income less than or equal to three minimum monthly salaries (81.3%) and less than eight years of schooling (69.8%); 90.6% of the patients were living with another person. The total number of pharmaceutical drugs was 406 (average of 4.2 medications per patient). The drugs most prescribed were antihypertensives (47.5%). The frequency of drug interactions was 66.6%. Among the 154 potential drug interactions, 4.6% were classified as major, 65.6% as moderate and 20.1% as minor. The high frequency of drug prescriptions with a potential for differentiated interactions indicates a situation that has so far been little explored, albeit a reality in household surveys.

Seguimiento de guías farmacoterapéuticas en mayores de 85 años con insuficiencia cardiaca estadio C. Efecto sobre la mortalidad al año

Objective To describe factors related to prescription on discharge of treatment for Chronic Heart Failure(CHF)-Stage C and to analyse whether this is related to 12month-mortality. Material and methods Observational follow-up study of patients over 85 hospitalized during 2006/7 with Stage C-Chronic Heart Failure in an outskirt support hospital. Drug-prescription adherence was assessed according to the American Heart Society 2005-Guidelines and recommendations of the American Geriatrics Society-2007. A multivariate analysis of logistic regression was performed to obtain odds for 12-month mortality for each recommended therapy, adjusting by mortality risk factors. Results 104 patients aged 90±3 yr were followed on discharge, 85% of which were women. NYHA-classes were distributed NYHA I-28,2%, II-37,9%, III-30,1%, IV-3,9%. Most frequently prescribed drugs were loop diuretics (83,3%) and IACEs/ARB (62%), and the less frequent beta-blockers (19,1%). IACEs/ARB were prescribed to those with lower functional impairment (p=0.04), and beta-blockers to those with worse NYHA class (p=0.02). All recommended prescriptions had a tendency to 12 month mortality risk reduction, even adjusted by age, functional status, co-morbidity, NYHA class and co-morbid atrial fibrillation, except for spironolactone (OR-1,8; IC95% 0,48–17,19). Conclusions Treatment with CHF disease-modifying therapies except for spironolactone can reduce 12 month risk mortality, also in the oldest old. There exists room for improvement in frequency of drug prescription in this group of age.

Impact de la conférence de consensus sur le traitement ambulatoire des bronchiolites du nourrisson: Étude sur 3 années dans le département du Nord

To assess the impact of guidelines of the consensus conference in September 2000 on the ambulatory management of acute bronchiolitis in infants.Prospective multicenter study, in four hospitals in the North department in France, during three epidemic periods: the winter preceding the consensus conference and the two following winters. All the infants between 30 days and 2 years of age, admitted to an emergency care unit for a first or second episode of bronchiolitis were included. The infants' characteristics and ambulatory treatments prescribed were collected.Six hundred thirty-eight infants were included: 169 before the conference and 469 after. Seventy-seven percent had consulted previously and a prescription had been drawn-up for 77%. There was no difference in the frequency of drug prescriptions or physiotherapy between the three periods. After the conferences, inhaled beta(2) agonists were still prescribed in 21% of cases, inhaled corticosteroids in 15%, oral corticosteroids in 34%, antibiotics in 53% and mucolytics in 54%. Physiotherapy was prescribed for 58% of the infants.Two years after the consensus conference, the ambulatory treatment of bronchiolitis has no changed, corticosteroids, beta(2) agonists, antibiotics and mucolytics are still prescribed in excess. Further studies, within a few years, are required to reassess the application of the guidelines, not only in outpatient but also in inpatient management.

Use of Spirometry and Respiratory Drugs in Manitobans Over 35 Years of Age with Obstructive Lung Diseases

Previous data indicated that spirometry was underused in people with obstructive disease, especially those with chronic obstructive pulmonary disease (COPD). To examine the use of respiratory drugs in patients with COPD and asthma, and to relate drug use to spirometry. Manitoba Health maintains a database of physician services remunerated by fees that includes spirometry. The database contains the diagnosis and patient identifiers, as well as sex, date of birth and residential postal code. Similar identifiers are used in the provincial pharmacare program that records prescriptions dispensed at retail pharmacies. These databases were examined for the time period between 1996 to 2000, and people over 35 years of age diagnosed with asthma, COPD or both were identified. The frequency of spirometry in these patients and their use of respiratory drugs was determined. Spirometry and drug prescription frequencies increased with the number of physician visits (including those for bronchitis), but their patterns differed. Patients with asthma or asthma plus COPD had considerably higher rates of drug prescription and slightly higher spirometry rates than did those with COPD. Patients with asthma and asthma plus COPD who underwent spirometry were slightly more likely to receive drugs than those who did not undergo spirometry; this trend was more striking in patients with COPD. However, approximately 30% of patients with COPD who had five physician visits and who underwent spirometry did not receive drugs; this was true for approximately 10% of similar patients with asthma. Patients with asthma generally received beta-agonists and inhaled steroids; these agents were less commonly given to patients with COPD, who instead were given anticholinergics much more often than were asthmatics. Patients who were diagnosed with asthma plus COPD had beta-agonist and inhaled corticosteroid prescription rates similar to asthmatics, and anticholinergic prescription rates similar to patients with COPD. Theophylline and antileukotriene drugs were used less often than were inhaled agents. In patients with asthma, drugs were frequently discontinued, and during drug use, prescription refills were consistent with an intake of 30.9% of the prescribed doses. In patients with COPD, discontinuing drugs early was uncommon, and refills were consistent with the use of 54% of the prescribed amounts. The same was true of patients with both COPD and asthma. Drug prescription was considerably more common in patients labelled with asthma or COPD plus asthma than in patients with COPD. Spirometry was also less common in patients with COPD but had a distinct influence on the frequency of drug prescription. Patterns of drug prescription were predictable, and patterns of drug use indicated poor compliance, in agreement with other data. The results suggest that COPD symptoms may be discounted and patients systematically undertreated or the diagnosis could frequently be applied to people with trivial disease or both.