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Biomedical subjects

G Boëthius

Publications and source records attributed to G Boëthius.

28 records · Page 2Linked to original sources
PubMed1991

Monitoring of drug prescriptions for children in the county of Jämtland and Sweden as a whole in 1977-1987.

One individual-based (Jämtland) and one population-based (Sweden) monitoring system provided information on the prescription sales of drugs for children in ambulatory care. The overall prescription rate decreased between 1977 and 1987 and it was 20-25% lower in Jämtland than in Sweden as a whole. Antibiotics, drugs for ear, nose and throat diseases and respiratory drugs accounted for three out of four prescriptions. Penicillin V dominated among antibiotics and the prescription rate was stable whereas that of other antibiotics increased. During their first year of life one out of ten children in Jämtland had at least one prescription of antibiotics, during their first five years three out of four children. Prescribing of decongestants, especially systemic, decreased during the study period whereas that of anti-asthmatics increased, partly due to the non-approved use of these drugs for common cough. The results from our study underline the need for pharmaco-epidemiological studies linking prescription data to clinical data in order to answer questions on the rational of present drug treatment practices.

Adolescent↗
PubMed1990

Measurement of drug use in a defined population. Evaluation of the defined daily dose (DDD) methodology.

To evaluate the accuracy of the DDD per 1000 inhabitants per unit time as an estimate of the fraction of drug users within a population, DDD figures have been compared with the proportion of apparent drug users, i.e. individuals in the population for who a prescriptions had been dispensed. An individual-based prescription monitoring project provided the necessary data for eight drugs representing continuous long-term medication, short-term medication and medication falling in between those two categories. For digoxin, the long-term drug, the number of DDD/1000 inhabitants/day was about 40% below the proportion of apparent drug users. The DDD figure for antibiotics ranged from 4% below to 28% above the apparent users, and for the remaining drugs it ranged from 17% below (bendroflumethiazide, 1982) to 80% below (naproxen, 1985). The DDD methodology is a valuable first step in overall drug use measurement, but for more precise estimates of drug use it must be supplemented by other techniques.

Drug Therapy↗
PubMed1990

Prescription monitoring of drug dosages in the county of Jämtland and Sweden as a whole in 1976, 1982 and 1985.

Prescribed doses of drugs for which individualisation of dosage is deemed necessary were recorded from one national and one local Swedish prescription monitoring study for the years 1976, 1982 and 1985. Dose patterns were analysed in order to determine whether the practice of individualising drug doses had become more widely adopted by physicians. Amongst drugs eliminated primarily by metabolism, (propranolol and amitriptyline were prescribed in highly variable doses (30-fold or more). The three commonest doses of these agents accounted for about 60% of the prescriptions. In general, doses decreased with increasing patient age. Prescribing practices for piroxicam differed markedly from those of propranolol and amitriptyline, with one fixed dose of piroxicam accounting for about 90% of all prescriptions. For drugs eliminated mainly by renal excretion (digoxin, cimetidine and atenolol) there was an 8-10-fold variation in the prescribed doses. The most frequent dose of these drugs accounted for 40-60% of the prescriptions. Doses of cimetidine and atenolol were lowered only in the oldest patients. The doses of digoxin decreased more evenly with increasing age, and were reduced in elderly patients on long-term maintenance therapy. The difference in digoxin dose between young and old patients increased during the study period. Prescription monitoring as a method for following-up drug usage may be instrumental in evaluating the effect of drug educational efforts.

Adolescent↗
PubMed1988

Approaches to assessing the rationality of drug usage in a developed country.

The prerequisites for analyses of the medical, social and economic consequences of drug usage are in part available in Sweden. Hard data, though, are still fragmentary. Examples are given where various data sources and methods have been applied. It is suggested that feedback of drug utilization data should increase to create a more questioning attitude among prescribers. The concept of medical audit has to be better explained including the fact that individual-based registers are necessary tools in trying to assess the rationality of drug treatment. In the future such analyses should focus on everyday treatment of common disease entities such as hypertension, diabetes, dyspepsia and asthma. Long term medical and economical consequences of optimized pharmacological versus non-pharmacological treatment should be studied.

Drug Utilization↗
PubMed1984

Effect of domiciliary treatment with nebulized beta 2-stimulants--a retrospective follow-up of 102 patients.

A retrospective follow-up of 102 patients with beta 2-stimulant nebulizers prescribed for domiciliary use was made to find out the extent to which the device was actually used, the effect on the need for hospital care and steroid treatment and the cause and place of death in relation to all asthma deaths. Of 53 patients seen in their homes, more than half used the nebulizer continuously. Two patients returned their nebulizers due to improvement of symptoms. A slight but not statistically significant reduction of hospital care was seen during a two-year period after the prescription compared to before. Patients with hypersecretion as the main problem seemed to benefit more by the treatment than obstructive patients. Asthma deaths outside hospital were not more frequent in patients with a nebulizer (84 per cent) than without (75 per cent). In two patients out of six dying from status asthmaticus outside the hospital, it could not be ruled out that the patient had relied too long on the bronchodilating effect of the nebulized beta 2-stimulant instead of coming to the hospital for additional treatment for the oedema and plugging. More information to patients about this risk is necessary.

Adult↗
PubMed1982

Utilization of analgesics from 1970 to 1978. Prescription patterns in the county of Jämtland and in Sweden as a whole.

A comparative analysis of the usage of analgesics in the county of Jämtland and in Sweden 1970-78 has been carried out. An attempt was also made to map out the indications for prescribing such drugs. Both in Jämtland and in Sweden as a whole, analgesics sold over the counter accounted for more than half of the total usage. The same was true for fixed drug combinations. Analgesics were prescribed each year to 17% of the population of Jämtland. Fixed drug combinations containing sedatives maintained a large fraction of the amount of analgesics prescribed--31% of defined daily doses (DDDs) in 1978. Arylalkanoic acids (ibuprofen and naproxen), introduced in 1975, soon took a substantial part of the market--13% of DDDs in 1978. Though arylalkanoic acids were registered for treatment of degenerative joint diseases, four of five patients in Jämtland received them only once or twice during a two-year period. In the national study, every third prescription of these drugs was for degenerative joint diseases. The pattern of usage revealed in this study calls for improved pharmacotherapeutic training of physicians to make drug treatment more rational.

Analgesics↗
PubMed1978

Doses and dosage intervals of drugs--clinical practice and pharmacokinetic principles.

Outpatient prescriptions dispensed to 17,000 individuals in the county of Jämtland, Sweden, have been analyzed with regard to doses and dosage schedules. Two groups of drugs were studied; one group with marked interindividual variability in metabolism (antidepressants, beta receptor blockers, and phenytoin), the other group excreted unchanged in the urine (digoxin, nitrofurantoin, sulfonamides, and tetracycline). A 25-fold-15-fold variability in daily doses was found for amitriptyline and nortiptyline, respectively. Four-fifths of the prescriptions were for doses between 30 and 75 mg, making the mean dose remarkably low-58 and 48 mg, respectively. The variability in doses was higher for the beta receptor blockers propranolol and alprenolol. Daily doses of phenytoin varied between 0.1 and 0.6 gm, 93% of the doses falling between 0.2 and 0.4 gm. Generally, doses of sulfonamides and nitrofurantoin prescribed to children were correctly reduced. In the elderly the doses of these drugs and tetracycline and digoxin were only moderately reduced in discrepancy with the physiologic impairment of kidney function. The clinical significance of these findings has not been evaluated. The effect of drug information programs on dosage intervals prescribed for procainamide, phenytoin, and beta receptor blocking drugs is demonstrated. It is suggested that more emphasis be given to general pharmacokinetic principles in drug information programs.

Adolescent↗