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PubMed2002

[Drug utilization and recommended conditions for use in children].

BACKGROUND: Studies carried out in other countries show that drugs are used in children outside the approved conditions, in a context in which investigation, information and authorization of medications in the pediatric population are scarce. OBJECTIVES: To evaluate the conditions of drug use recommended in children and variability in sources of drug information. METHODS: We performed a descriptive, retrospective study. Data on medication consumption in 1997 were obtained from a pediatric university hospital. Information on conditions of drug use in children was analyzed using a Spanish catalog of medications. This information was compared with that of a North American catalog for international reference. RESULTS: Most of the drugs used were of unrestricted (43; 47 %) or restricted (26; 28 %) pediatric use, but drugs that are not recommended (8; 9 %) or those with unspecified conditions of use in children were also used (15; 16 %). Approximately 12 % of the drugs were not identified in the North American catalog; of the remaining drugs, 60 % were of unrestricted pediatric use, 35 % of restricted use and 5 % were not recommended. CONCLUSIONS: A substantial proportion of drugs administered to hospitalized children are not recommended or their possible use in this population is not specified. It is worth encouraging research, having sources of information that help to make decisions, especially in conditions that have not been approved, and adapting regulatory attitudes, as far as possible, to the evidence and therapeutic needs.

Adolescent↗
PubMed1988

Early neonatal drug utilization in preterm newborns in neonatal intensive care units. Italian Collaborative Group on Preterm Delivery.

The pattern of drug use in preterm newborns admitted to neonatal intensive care units (NICU) was monitored as part of a large multicenter study including a representative sample of Italian NICUs. All prescriptions from the admission of the mother through the 1st week of the neonate's life were carefully documented on standardized ad hoc forms, with particular attention to the timing and duration of each prescribed drug. The 706 babies included in the surveillance program received an average of 1.7 drugs during the early neonatal period, and were exposed to an average of 3.4 drugs over the whole perinatal period. The most commonly used drugs postnatally were vitamins, antibiotics (ampicillin, gentamicin and tobramycin), methylxanthines (aminophylline and caffeine), phenobarbital and furosemide. The frequency and intensity of the use of these drugs appears to be directly related to the severity of the clinical status, and inversely related to birth weight and gestational age.

Adrenergic beta-Agonists↗
PubMed2006

Drug utilization pattern in the intensive care unit of a tertiary care hospital.

The authors studied the factors affecting drug use pattern, cost of therapy, and the association between the pattern of drug use and survival as well as the duration of stay in a prospective, observational study in an intensive care unit between February and May 2005. Data were collected regarding drugs used, severity of the disease, and their outcome. The mean +/- SD of the Acute Physiology and Chronic Health Evaluation (APACHE III) and Glasgow Coma Scale (GCS) scores of 84 patients were 52.2 +/- 19.4 and 7.5 +/- 2.4, respectively. Although the mean number of drugs at the time of admission to the intensive care unit was 5.3, it increased to 12.9 on the first day and 22.2 during the entire stay. More than 50% of the average expenditure on drugs and nutrition was accounted by antibiotics. Requirement of insulin or inotropes signified an adverse outcome on mortality (odds ratios of 3.43 and 8.44, respectively). In conclusion, there is a tremendous impact of antibiotic use on the cost of therapy in the intensive care unit. The requirement of certain drugs such as insulin and inotropes is of prognostic significance.

APACHE↗
PubMed1991

Recent trends in the prescribing of cholesterol lowering drugs in Australia. A report from the Drug Utilization Subcommittee of the Pharmaceutical Benefits Advisory Committee.

OBJECTIVE: To determine the recent pattern of use of hypolipidaemic drugs in the Australian community. DESIGN: Drug utilisation study employing prescription data collected during the operation of the Australian Pharmaceutical Benefits Scheme (PBS). SETTING: Non-hospital drug use in Australia. PATIENTS: All patients, pensioners and non-pensioners, who received prescriptions for hypolipidaemic agents under the PBS between January 1987 and December 1989. MAIN OUTCOME MEASURES: The total number of prescriptions, average quantity dispensed with each prescription, defined daily doses (DDD) and Australian population figures for pensioners and non-pensioners were used to express the consumption of hypolipidaemic agents as DDD/1000 individuals/day. RESULTS: Between the March quarter 1987 and the December quarter 1989 prescribing of hypolipidaemics for the Australian community increased from 68,120 to 304,760 prescriptions per quarter, which translates to a rise in use from 1.2 to 5.2 DDD/1000 inhabitants/day. This included a rise in the use of clofibrate from 0.6 to 2.6 DDD/1000 inhabitants/day, and of cholestyramine from 0.6 to 1.9 DDD/1000 inhabitants/day. Prescribing of hypolipidaemics for pensioners increased from 29,569 to 123,440 prescriptions per quarter. This translated into a rise in use from 3.7 to 14.8 DDD/1000 pensioners/day. Notable rises were seen for clofibrate, 1.9 to 8.1 DDD/1000 pensioners/day, and cholestyramine, 1.6 to 4.7 DDD/1000 pensioners/day. In comparison published data from the Nordic countries and the United States showed a lower overall use of hypolipidaemics and declining consumption of clofibrate. CONCLUSIONS: The trend in Australia was unusual in that the use of clofibrate increased to a greater extent than that of the resins, cholestyramine and colestipol which are generally preferred for treatment of hypercholesterolaemia. Possible reasons for this include: the better tolerability of clofibrate; its readier availability during the study period; the recommendation by the Pharmaceutical Benefits Advisory Committee that clofibrate was the preferred drug when triglyceride levels were also elevated and the limited availability of newer hypolipidaemic agents.

Aged↗
PubMed1988

Dobutamine: a drug utilization evaluation.

During a recent fiscal year, a 243% increase in dobutamine costs--which were associated with increased drug use--was observed at Brigham and Women's Hospital in Boston. As a result of this increase, a drug usage evaluation was concluded to determine: the indications for which dobutamine was being prescribed, whether or not dopamine could be used in place of dobutamine, and any anticipated cost savings realized by targeting dobutamine prescribing. Forty-six consecutive patients who were receiving dobutamine for hypotension, congestive heart failure, or decreased urine output were evaluated during a 3-month study period. The results indicated that dopamine could have been used as initial therapy in the majority of patients. In only 3 patients was dobutamine considered the drug of choice. Furthermore, the institution could have reduced drug costs by more than $50,000 if the use of dobutamine could have been reserved for its most appropriate indications.

Boston↗
PubMedDate not supplied

[Effect of non-medical factors on drug utilization in perinatal hospital practice].

INTRODUCTION: Beside medical, nonmedical factors also influence the quantity and structure of administered drugs. Therefore, it is of importance to analyze these factors and their influence on drug consumption in perinatological hospital practice. The aim of this study was to analyze pharmacotherapeutic practice as well as the influence of nonmedical factors on drug use at the Institute of Perinatology of the Department of Obstetrics and Gynaecology in Novi Sad. MATERIAL AND METHODS: The study was of retrospective-prospective character. Analyses comprised drug consumption for the period 1989 and the first 6 months of 1993 and 1994 analyzing data obtained from the hospital pharmacy. Due to lack of drug supply in the hospital pharmacy and domestic market, a sample of 10% patient's histories were taken for analysis in order to compare the above data for the same time interval. All drugs were classified according to the unique ATC (Anatomical Therapeutic Chemical) classification, where the Defined Daily Dose (DDD) was taken as the drug use statistical unit. RESULTS AND DISCUSSION: According to the data from the hospital pharmacy, the total drug consumption in 1989 was 7301,85 DDD/BD and in 1993 and 1994 it was significantly decreased (1993--5135,80 DDD/1000 BD vs. 1994--2095,90 DDD/1000 BD). Majority of drugs for all the investigated periods were administered for the group G (urogenital system and sex hormones) out of which most often used drugs were G02A (drugs for stimulation of uterine contractions). According to the patients' history data, drug use was significantly increased in 1993--6322,22 DDD/1000 BD and 1994--3340,01 DDD/1000 BD. The only exception was group A (alimentary tract and metabolism) in which, according to history data, drugs were significantly less frequently prescribed than supplied. The greatest difference in the quantity of prescribed drugs (patients' history data) and the drugs issued from the hospital pharmacy was recorded in the group C (cardiovascular system), G (urogenital system and sex hormones) and H (hormones for systemic use with sex hormones excluded). Prescription of drugs from the groups C and H respectively, according to history data was most probably justified, but a question is raised concerning high rate of drug prescription in group G.

Drug Utilization↗
PubMed1995

Drug utilization study during pregnancy.

The history of drug registration in most developed countries has been strongly influenced by the dramatic thalidomide disaster. A systematic hand search identified all women who delivered between September 1st 1993 and June 1st 1994. A total of 2389 mothers were set against the Australian Classification of Drugs with respect to their known or suspected risks in pregnancy. According to the interview after delivery, and from the hospital files, the prescription rate of all drugs increased from 15% in period-1 (two months before pregnancy), to an average of 65.66% during pregnancy. We could divide the groups of drugs used during pregnancy into major and minor groups according to the number of women who ingested drugs in the different trimesters. 1. In the first trimester, women received major amounts of blood-forming drugs, vitamins and electrolytes, hormones, anxiolytics, antibiotics and GI drugs. 2. In the second trimester, women received major amounts of blood-forming drugs, vitamins and electrolytes, anti-infectives, anxiolytics, tocolytics and antihypertensive. 3. In the third trimester, women received major amounts of blood-forming drugs, vitamins and electrolytes, tocolytics, anxiolytics, anti-infectives, antithrombotics and antihypertensive. The drug groups mentioned above have been set according to it's decreasing use respectively.

Animals↗