How can the medical staff interact with pharmacists to improve drug utilization practices in hospitals?
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Norway participated in an international multicenter study on drug use, smoking, alcohol consumption, antenatal care, and complications in pregnancy. 482 women were interviewed at Akershus Central Hospital (near Oslo) and Haukeland hospital (in Bergen). Interviews were conducted during one of the first days after delivery using a standardized form. We found that 75% of the pregnancies were planned, while 7% were the result of contraceptive failure. 35% of the women smoked during pregnancy, compared with 43% before pregnancy. However, in relation to the early period of pregnancy the amount of tobacco consumed and the percentage of smokers increased slightly towards the end of pregnancy. Women who smoked were hospitalized during pregnancy more often than non-smokers. 91% of the women used some kind of medication during pregnancy including iron and vitamins.
The present paper analyzes the consumption of drugs in the out-patient health care for city population in relation to age and sex. An automated information system of processing of medical prescriptions by means of computer technique was used. Drug consumption is expressed in the form of costs. The drug consumption for 1984 in the whole population of a city with more than 400 thousand inhabitants was evaluated. Population was divided into 17 age groups (5 years in each) always separately within sex. The results show that drug consumption calculated per 1 person up to the age of 30 is affected by age only negligibly. In the population over 30, drug consumption is markedly increased with age up to the highest age categories. Mathematical analysis has demonstrated that the relation of drug consumption to age expressed per 1 person is best portrayed by a second-degree parabola.
The author pays attention to the drug consumption of the population, particularly of the economically active population. Special attention was devoted to an analysis of drug consumption in the above population group during periods of work incapacity. The investigation was based on used medical prescriptions. It was revealed that the economically active population participates in drug consumption by cca 50%, whereby the drug consumption of the population during work incapacity is cca 30% of consumption by the economically active population and accounts for cca 15% of the drug consumption of the entire population.
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A study was carried out to determine whether it would be feasible to use record linkage for monitoring adverse effects of drugs. For a total population of 43 117 people, all prescriptions dispensed during a two-year period were linked with records of hospital admissions, obstetric deliveries, and deaths (in or out of hospital). For another population of 10 453 people, prescriptions were linked with information about illnesses recorded by general practitioners. In both cases, the data were analysed to reveal associations between drugs and diagnoses. It was concluded that record linkage would be valuable for detecting unsuspected hazards of drugs, and for testing hypotheses from other sources. The opportunities for this type of research are greatest in countries with highly organized health services, such as the Scandinavian countries and the United Kingdom.
OBJECTIVE: To investigate how hypnotic drugs are used in Spain, specifically, (1) to characterize the user population in some simple demographic (e.g., sex, age) and clinical (e.g., type of insomnia, type of physician who prescribed the drug) variables; (2) to estimate the proportion of long-term users (> 3 mo); (3) to determine the frequency of different administration schedules; (4) to determine whether the kind of hypnotic drug prescribed according to the duration of its effect correlates with the type of sleep disorder or patient age; and (5) to compare the dosage used by the elderly with that used by adults. DESIGN: Cross-sectional pharmacy-based study. SETTING: A network of 318 community pharmacies throughout Spain. SUBJECTS: Patients (n = 5324) requesting a hypnotic drug for insomnia who agreed to take part in the study. MAIN OUTCOME MEASURES: Distribution of the use of hypnotic drugs by age, sex, type of insomnia, type of physician, specific hypnotic drug, daily dosage, treatment schedule, and duration of treatment. RESULTS: Women (67%) and the elderly (58%) constituted the largest subgroups in the sample. Difficulties in sleep onset and in sleep maintenance as single disorders were reported by 38% and 37% of users, respectively. Prescriptions were written by general practitioners in 80% of cases. Daily use was reported by 88% and long-term use (> 3 mo) by 72% of the users. Long-term treatment was two- to threefold more frequent in the elderly than in middle-aged subjects. Intermediate-action hypnotic drugs were used by 59% of subjects, short-action drug by 24%, and long-action drugs by 17%. The type of hypnotic drug prescribed was not related to the kind of sleep disorder or the age of patients. Specialists prescribed long-action hypnotic drugs more often than did general practitioners. No relevant differences were observed between dosages used by the elderly and those used by adults. In both groups the dosage taken by most patients, regardless of the drug, corresponded to the available strength. Substitution drugs for triazolam belonged to the intermediate-action class in 53% of the cases. CONCLUSIONS: Recommendations on hypnotic drug use are largely not followed in Spain. Most patients are taking hypnotic drugs daily, over long time periods, and without an adequate dosage titration according to age. Measures should be taken to correct this situation.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.