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At least 325 records · Page 18Linked to original sources
PubMed1994

The impact of formulary reservations on drug utilization: a controlled trial.

A controlled trial was conducted in two teaching hospitals (A and B), with similar case mixes to determine the impact of reservations, which were educational in nature, on the utilization of oral ciprofloxacin. Over a two-month period the health records of all the patients who received the drug were reviewed, and information on utilization and demographics of patients receiving the drug was recorded. As well, the number of admissions to the two hospitals over this period were compared. If culture and sensitivity (C & S) results were available, appropriateness was assessed in accordance with criteria for use established at site A; in the absence of C & S information, consensus by two microbiologists was used. Over the two-month period a total of 136 patients received ciprofloxacin at the two institutions. At site A, which had reservations, the number of patients who continued to receive ciprofloxacin upon admission was significantly decreased relative to site B, which did not have reservations (14% vs. 36% respectively, p = .029). As well, when assessed by total number of admissions to the institutions, the number of patients receiving ciprofloxacin at site A was less than site B (1.5% vs. 2.6% respectively, p = .003)). While the utilization was decreased at site A vs. site B, the proportion of patients with therapy deemed to be appropriate was not different between the two sites. Educationally based reservations are an effective formulary tool for optimizing drug utilization.

Aged↗
PubMed2005

Antidiabetic drug utilization in hungary.

OBJECTIVE: To evaluate the utilization trends of antidiabetics in Hungary. METHOD: The analysis includes the drugs of antidiabetic therapy which were registered between 1998 and 2002 in Hungary. The consumption of antidiabetic drugs was analyzed by the ATC/Defined Daily Dose (DDD) method. The data used in this study were derived from the National Health Insurance and from MIS Consulting Company. RESULTS: Between 1998 and 2002, the total consumption of antidiabetics increased by 41.8%, and reached 47.59 DDD/1000 inhabitants/day in 2002. The consumption of oral antidiabetics (OAD) increased by 33.41% (33.86 DDD/1000 inhabitants/d ay in 2002), while in the case of insulin the increase was 67.8% (13.74 DDD/1000 inhabitants/day). Sulphonylureas were the most frequently used class (21.11 DDD/1000 inhabitants/day in 2002). Glibenclamide was the most frequently used antidiabetic drug (12.63 DDD/1000 inhabitants/day in 2002). CONCLUSION: The insulin class had greater emphasis in therapy. Among OAD, the consumption rate of sulphonylureas decreased and the consumption rate of Biguanides and acarbose increased. By 2002 metformin replaced 90% of the buformin in use. The limited effect of therapeutic recommendations could explain these changes, although the out-of-date buformin and the non-micronized glibenclamide were still in use in 2002.

Acarbose↗
PubMed1985

[Drug utilization in 3 nursing homes for somatic patients].

An investigation was carried out of the drug-use of 198 patients in three nursing homes. Almost 80% of the patients used 2 to 7 drugs. The average number of drugs per patient relating to regular medications for internal use was 4,36. It was 5,25 when p.r.n. medications and medications for external use were also included. The most frequently used drugs were psychotropics, analgetics, cardiac drugs, diuretics and laxatives. Combinations of drugs (including alcohol) that can lead to interaction, were often prescribed. The following combinations were found to have the highest frequency: two drugs with anticholinergic action, digoxin with a potassium-loosing diuretic, two or more drugs which can cause hypotension. The number of patients with one or more of these combinations as well as the number of combinations per patient increased in correspondence with drug-use per patient.

Aged↗
PubMed1979

Drug utilization and prescribing patterns in a skilled nursing facility: the need for a rational approach to therapeutics.

A study was made of 50 patients drawn at random from a Skilled Nursing Facility (SNF) attended by seven physicians. For 59 percent of these patients, polypharmacy was practiced but no substantiating diagnoses were recorded. Approximately half of the drugs were administered pro re nata. More drugs were prescribed in potentially toxic dosages than in subtherapeutic dosages. The risk of an adverse drug reaction (ADR) was most often associated with anticholinergic agents, sedative-hypnotic drugs, and neuroleptics (thioridazine and chlorpromazine), particularly when prescribed concurrently. Risk of an ADR was highest when a drug was prescribed without recording a definite diagnostic indication. Lack of consistency by individual physicians in their approaches to the therapy of similar disease entities in comparable patients tended to support the concept of peer review in SNFs and also the need for teaching a rational approach to therapeutics in SNFs based on clinical pharmacology as applied to the elderly.

Aged↗
PubMed1993

An equilibrium model of drug utilization.

We propose an equilibrium model to assess the dispensing pattern of non-steroidal anti-inflammatory drugs (NSAIDs) among members of a health maintenance organization. The model incorporates observed patterns of patient switching among NSAIDs and identifies an implicit equilibrium distribution of drug dispensing, which may be used both to identify aberrations in prescription practice and to forecast the expected utilization of newly introduced drugs. NSAID dispensing patterns were stable for most quarters from 1987 to 1990. Introduction of two new NSAIDs and initiation of a pharmacy co-payment coincided with transient perturbation of the patterns. Dispensings of recently introduced NSAIDs achieved their equilibrium values in less than 2 years.

Adult↗
PubMedDate not supplied

Age differences in HIV risk behaviors and drug treatment utilization among drug users in Kentucky.

The purpose of this study was to (1) profile demographic and other characteristics of two age groups, younger aged 30 to 39 (N = 643), and older aged 40 to 49 (N = 395), (2) examine and identify differences in lifetime drug use patterns and age of drug use initiation, (3) examine HIV risk behaviors: drug use and sexual practices, (4) compare drug user treatment utilization between the two age groups, and (5) examine barriers to drug is treatment utilization by gender. The study sample (N = 1038) was drawn from individuals recruited into the NIDA Cooperative Agreement in Kentucky. The median age in the study sample was 38, the majority were male (72%), and African-American (81%). Results indicate that older subjects initiated drug use at a later age than younger subjects. Compared to the younger age group, significantly more subjects in the older group reported having ever used any of the 10 drugs examined. Injection drug use patterns and lifetime sex exchange practices were more prevalent in the older age group. Older subjects also were more likely to utilize drug user treatment, specifically methadone maintenance treatment. When barriers to drug user treatment were examined, significantly more women than men did not qualify for treatment, and they did not have enough money for treatment. Implications for interventions are discussed.

Adult↗