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Biomedical subjects

Michele Tari

Publications and source records attributed to Michele Tari.

3 recordsLinked to original sources

Antidepressant drugs: prevalence, incidence and indication of use in general practice of Southern Italy during the years 2003-2004.

PURPOSE: To estimate 1-year prevalence, 1-year incidence and indication of use of antidepressant (AD) drug treatment in general practice of Southern Italy during the years 2003-2004. METHODS: Among 142,346 individuals registered in the lists of 119 general practitioners of Southern Italy, we identified users of different AD types: tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) and other antidepressants. Annual prevalence of AD use was measured as the number of individuals receiving at least one AD prescription in the years 2003-2004, divided by the number of patients registered in the general practitioner (GP) lists. One-year incidence of AD treatment was calculated as the number of new users of AD, divided by the number of total patients free from AD prescriptions in the previous year. RESULTS: Overall, 1-year prevalence of AD use was 5.08 (95% confidence interval (CI): 4.97-5.20) per 100 inhabitants in the year 2003, with a 20% increase in 2004 (6.00, 5.88-6.13). Prevalence of SSRI use markedly increased from 3.80 (3.73-3.90) in 2003 to 4.51 (4.40-4.61) in 2004. The incidence rates of SSRI, TCA and other antidepressant use were 2.11 (2.03-2.19), 0.38 (0.35-0.41) and 0.53 (0.49-0.57) respectively. Depressive disorders were the main indication of use of any AD user (mostly for SSRI users), followed by anxious disturbances. CONCLUSIONS: SSRIs, particularly those recently marketed, have been increasingly used during the last years, mainly to treat affective disorders.

Adult↗

Interaction risk with proton pump inhibitors in general practice: significant disagreement between different drug-related information sources.

AIMS: To compare information on drug-drug interactions (DDIs) reported on two standard drug-related information sources (Summary of Product Characteristics and Drugdex system by Micromedex), by assessing the prevalence and predictors of potential DDI with proton pump inhibitors (PPIs) in general practice. METHODS: From the 'Caserta-1' Local Health-Service database, 156 general practitioners (GPs) were recruited. From more than 180,000 individuals registered on their lists, we selected patients receiving co-prescription of PPI and medications at interaction risk, according to the Italian Summary of Product Characteristics (SPC) of PPI and Drugdex information, during the year 2003. Thereafter, we carried out a regression analysis to identify the predictors of co-prescription at interaction risk with PPI, on the basis of the two information sources. A number of analyses were performed to evaluate agreement on DDI information between the SPC of PPI and Drugdex. RESULTS: According to SPC and Drugdex, 324 (3.0%) and 958 (9.0%) patients, respectively, received co-prescriptions of PPI and potentially interacting medications during the study period. PPI users' age, type of medication and number of other drug prescriptions per month were independent predictors of receiving co-prescriptions at interaction risk, when considering only Drugdex. With regard to potential DDIs with PPI, a significant disagreement (P < 0.0001) between the two drug-related information sources, was shown through agreement analyses. CONCLUSIONS: Potential DDIs with PPI are a common health issue in general practice. Estimates of prevalence and predictors of potential DDIs with PPI significantly changes according to the drug information source being used.

Adolescent↗

Statin-macrolide interaction risk: a population-based study throughout a general practice database.

INTRODUCTION: The myopathy risk associated with statin use increases in case of concomitant prescription of certain drugs, such as cytochrome P(450) (CYP) system inhibitors (i.e., macrolides). The aim of this study was to assess whether concurrent statin/macrolide prescriptions at high interaction risk are commonly written in a general practice setting. METHODS: For this study, 156 general practitioners (GPs) with a patient population of almost 200,000 individuals, and participating in the Arianna database set up by "Caserta-1" Local health-Service Agency (ASL), were recruited. Within such a study sample, subjects receiving at least one statin/macrolide concomitant prescription during the year 2003 were identified. Sensitivity analysis was performed to assess the time distribution of high-risk macrolide prescriptions written within +/-10 days from the statin prescription date. RESULTS: Among 190,124 patients included in the study, 7,176 (3.8%) received at least one statin prescription during the observation period. Of these, 228 (3.2%) were occasionally co-prescribed with any macrolide on the same date, in 153 cases (2.1% of statin users) the macrolide being of high interaction risk. In particular, 2.1% (55) of simvastatin users and 2.2% (64) of patients on atorvastatin were prescribed with high-risk macrolide on the same date versus 0.6% and 1.8% of patients prescribed with fluvastatin and pravastatin, respectively. Concerning GPs, 99 (63.5%) co-administered statin and macrolide at high interaction risk at least once. CONCLUSIONS: Most GPs occasionally prescribed statin/macrolide at high interaction risk on the same date, despite the availability of therapeutic alternatives. Prevention strategies targeted to increase awareness of health professionals about the interaction risks of widely prescribed drugs are needed.

Adolescent↗