[Uppsala at the bottom, Kopparberg at the top of the glaucoma list. Big differences in drug utilization].
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OBJECTIVE: To determine the pattern of use of non-steroidal anti-inflammatory drugs (NSAIDs) in the Australian community, 1990-1994. DESIGN: Data from the national drug utilisation database were expressed in defined daily doses per 1000 population per day (DDDs/1000 population per day). Temporal trends were assessed and comparisons were made with NSAID use in other countries. Epidemiological data were used to estimate the likely impact of changing NSAID use on peptic ulcer hospitalisation rates. SETTING: Australian community (excluding hospitals). MAIN OUTCOME MEASURES: Estimated consumption of prescription NSAIDs, expressed in DDDs/1000 population per day. RESULTS: NSAID use in the Australian community fell from 50.1 DDDs/1000 population per day in 1990 to 34.6 DDDs/1000 population per day in 1994 (down 31%). From this reduced exposure we estimated that the number of admissions for NSAID-related upper gastrointestinal complications will have fallen by about 400 per year. Market research data for this period show a lower percentage use of NSAIDs for osteoarthritis and a decrease in the proportion of use in age groups over 50 years. CONCLUSIONS: The level of use of non-steroidal anti-inflammatory drugs in Australia has been high in comparison with other countries, but in recent years has fallen markedly. This fall occurred in conjunction with regulatory interventions, educational campaigns and increased concern in the medical and lay press regarding the risks associated with the use of NSAIDs.
OBJECTIVES: The purpose of the study was to use prescription data from a Danish database to analyse and evaluate antiepileptic drug (AED) utilization, and compare with other prevalence studies. METHODS: A Danish research database covering outpatient prescription data from a population of 471,873 persons was used. Prescription records on all patients prescribed AEDs during 1998 were retrieved. A cohort was extracted from the group of AED users. RESULTS: We identified 5426 AED users. A total of 3756 of the 5426 AED users were included in our cohort. Of the subjects in the cohort 74% were on monotherapy, 19% used two AEDs and only 7% used three or more AEDs. The eight most frequent regimens were all monotherapy: carbamazepine, oxcarbazepine, phenobarbital, valproic acid, lamotrigine, clonazepam, phenytoin and primidon in that order. The estimated crude 1-year prevalence of AED use was 0.77% for women and 0.83% for men (P<0.001), and it increased with age for both genders. CONCLUSIONS: The prescription pattern reported here is in accordance with the general guidelines for the treatment of epilepsy in Denmark, except for a surprisingly extensive use of phenobarbital. With specific reservations the figures appear to be reasonable estimates of the prevalence of epilepsy.
1 A prescription database study was conducted to describe the out-patient utilization of neuroleptics in the Odense area (207,000 inhabitants) during a period of 1 year. 2 Neuroleptic drug use is widespread, the period prevalence being 2.45% of the population. 3 The prevalence increases with increasing age. Fifteen percent of the population aged 90 years or more received neuroleptic drugs in spite of the many warnings against side effects in the elderly. 4 Estimated daily doses of neuroleptics were considerably lower than the Defined Daily Dose, probably as a reflection of many neuroleptics being prescribed to non-psychotic patients, in whom lower doses are used. 5 For perphenazine, a comparison of estimated daily doses from this study with doses from patients whose treatment had been adjusted by plasma concentration monitoring showed that generally much lower doses were used by patients included in this study.
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A large proportion of the residential and nursing home population is mentally ill. The causes for increased prescription of psychotropic drugs other than mental disorders have been discussed. This study presents data on the role of the individual's characteristics and institutional conditions on psychotropic drug use in residents of residential and nursing homes. Therefore the psychotropic drug use of 4 old-people's homes in Leipzig (Germany) was reviewed. Sociodemographic characteristics and a number of behavioral patterns of the residents were examined. Regression analysis revealed associations of age, gender and certain behavioral patterns (e.g., agitation, insomnia with nightly disturbances) and psychotropic drug use. Beyond that, psychotropic drug use varied among the 4 institutions' practices. Further research should be aimed at gaining insight into the interplay of these individual and institutional influences on psychotropic drug use in order to develop specific interventions to optimize treatment.
During an Integrated Quality Control (IQC) project for finishing pigs, the application of veterinary drugs was registered by means of a logbook on 75 pig finishing farms. Investigated is as to how far the application of veterinary drugs to animals is linked up with clinical observations, management and climatic conditions on the farm and to what extent the application of veterinary drugs is linked up with the occurrence of pathological findings in pigs at the slaughterhouse. The results indicate that more veterinary drugs are used as there are more clinical findings on a pig farm. This is particularly true for the autumn-winter period. Farms that use more veterinary drugs have a higher percentage of pigs with pathological findings at the slaughterhouse. As the point of time of treatment of respiratory disorders is closer to the slaughter date, there is a higher percentage of pigs suffering from pneumonia at the slaughterhouse. Farms treating pigs in the first thirty days of the finishing period against intestinal disorders have a distinct higher percentage of pigs suffering from pneumonia at the slaughterhouse. It appears that less veterinary drugs are used at farms having specific housing and management characteristics.
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OBJECTIVE: Obtain a picture of non-psychiatric medication use and depressogenic medication use by elderly people suffering from depression. DESIGN: Cross-sectional, self-reported by respondents. METHOD: Information about medication usage and the presence of chronic diseases was obtained from 183 depressive respondents and 96 control respondents. The respondents were aged 55 years or over. They were recruited between April 1996 and May 1998 in the provinces Groningen, Drenthe and Friesland, the Netherlands. Recruitment was via Regional Institutes for Outpatient Mental Health Care (RIAGGs), a psychiatric outpatient clinic, general practitioners participating in the 'Groningen longitudinal ageing study' (GLAS), a survey under the elderly within the general population, and screening with the 'Geriatric depression scale' (score > or = 6) in the GLAS main file. RESULTS: Respondents with subsyndromal depression recruited via screening were prescribed more depressogenic medication (mean: 3.26 drugs per patient, of which 45.6% depressogenic) than the control group (respective figures: 1.78; 26.1%) and the depressive groups recruited via general practitioners (2.77; 31.8%) or those recruited via RIAGGs/psychiatric outpatient clinic (2.60; 38.3%).