Biomedical subjects

Vincenzo Arcoraci

Publications and source records attributed to Vincenzo Arcoraci.

5 recordsLinked to original sources

PubMed2007

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↗

PubMed2006

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↗

PubMed2005

Cosmetovigilance survey: are cosmetics considered safe by consumers?

Cosmetics are largely diffused substances topically applied to wash, to perfume or to improve the look, nevertheless the number of reported adverse reactions is very low, probably because of underreporting. This could be due to self-diagnosis and self-medication that is common in the presence of not severe reactions. In fact adverse reactions to cosmetics are generally not serious and frequently related to skin alterations. The aim of our study was to assess, through a questionnaire supplied by community pharmacists to the customers, the prevalence and characteristic of adverse cosmetic events (ACEs) reported by interviewed and the consequent measures adopted. To this aim ten Naples' community pharmacies were involved and pharmacists agreed to submit a specific questionnaire to all the customers of the pharmacy for two weeks between 9:00 a.m.-01:00 p.m. and 04:00 p.m.-08:00 p.m. from 1 to 15 June. The subjects interviewed were 4373, of them 845 refused to fill the questionnaire. Females responding to the questionnaire were 2716 and males 812. The 98.5% of the respondents reported to use cosmetics. Cosmetic users who experienced at least one ACE were 848 and 18.2% of them reported more than one event. Total adverse cosmetic events reported were 1507. A significant higher prevalence of adverse cosmetic events in women was observed, since the 26.5% of female cosmetic users experienced an adverse cosmetic event, whereas the percent was 17.4 for males. Concerning the type of adverse event, the 95.9% was a cutaneous event, whereas systemic events accounted for 4.1%. Among cutaneous reactions burning and itching were the most prominent and accounted for 36.3 and 32.9%, respectively. The most frequently reported systemic event was headache (40.3%) followed by nausea (24.2%). Product change (45.7%) and product suspension (39.6%), were the main specific measures adopted in the presence of ACEs. The general practitioner or the pharmacist were consulted only in the 6.8 and 6.3% of the episodes, respectively. In the 56.5% of the episodes consultation was not requested, whereas in the 26% a specialist was consulted. In conclusions our results, although supply information about ACEs and the consequent measures adopted by consumers of a restricted geographical area suggest that, due to the large use of these products and the relative high incidence of reported ACEs, the problem of cosmetic related injuries and the need of a system able to report, collect and evaluate them, cannot be ignored.

Consumer Behavior↗

PubMed2005

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↗

PubMed2002

Exploring the variability in antibiotic prescribing profiles among paediatricians from two different areas of Italy.

We carried out a multicentre community-based study in order to describe the antibiotic therapeutic approach of paediatricians from two different areas of Italy in the treatment of respiratory tract infection (RTIs), and to assess which factors are involved in a possible variability of prescribing habits. Forty paediatricians participated in the study between October 1998 and April 1999. They had to complete a questionnaire for each therapeutic intervention resulting in an antibiotic prescription. A logistic regression model was used to identify possible predictors in choosing parenteral antibiotics for the treatment of RTIs. In 2 975 questionnaires of antibiotic treatment, RTIs represented 90.2% of the total antibiotics used. Upper respiratory tract infections were the most commonly treated diagnostic group (59.6%), followed by lower respiratory tract infections (20.4%), and middle ear infections (19.8%). Statistically significant differences between northern and southern Italy were reported in the antibiotic prescription profile and the duration of the therapy. Another marked difference was reported in the frequency of laboratory analysis requests. The logistic regression model indicated that the use of parenteral antibiotics appears significantly related to the type of infections [lower RTIs: (OR: 3.99; 95% CI: 2.49-6.37)], the geographic location [northern Italy: (OR: 0.20; 95% CI: 0.20-0.39)], and the presence of concurrent diseases (OR: 3.21; 95% CI: 1.46-7.02). The lack of adherence to clinical guidelines and the marked variability of antibiotic prescription rates between different areas of the country appear to be related to factors other than bacterial resistance, and highlight the importance of carrying out educational programmes targeted at the national level for improving the antibiotic prescription habits for the treatment of RTIs.

Anti-Bacterial Agents↗