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Prescribing Trends (prescribing + trend)
Selected AbstractsAntipsychotic prescribing trends: a review of pharmaco-epidemiological studiesACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010H. Verdoux Objective:, To review findings from pharmaco-epidemiological studies exploring antipsychotic (AP) drugs prescribing trends. Method:, We retrieved original studies that explored AP prescribing trends in general population samples since 2000. For each study, we extracted information on sampling method, period, assessment of AP use and corresponding estimates (incidence rates, prevalence rates, pharmacy sales, prescription data) and diagnostic assessment. Results:, Nearly all studies meeting the inclusion criteria (n = 17) showed an increase in AP prescriptions, mainly because of a dramatic rise in second-generation antipsychotics (SGAP) prescriptions. APs are often prescribed for non-psychotic disorders in adults as well as in children and adolescents. Conclusion:, Considering the growing number of persons from the general population exposed to APs, population studies assessing the risk/benefit ratio of SGAP use in disorders other than psychosis are necessary, particularly in children and adolescents. [source] UK interventions to control medicines wastage: a critical reviewINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2010Katherine Gwenda White Abstract Objective The objective is to evaluate the scope of medicines wastage in the UK, assigning a value to the costs at both a national and individual patient level to assess the cost-effectiveness of the pharmacy interventions that have been introduced to curb wastage. Methods Publicly available information was assessed in a desk-based systematic review using online search engines and publication databases. Data on community prescribing trends and costs in England from 1997 to 2008 from the Department of Health, and published reports from Primary Care Trusts (PCTs) comprise the core information that has been analysed. Key findings The commonly used upper wastage estimate of 10% is likely to be overstated, because it pre-dates major measures to curb wastage and over-prescribing. In pilot programmes, medicines use reviews have achieved cost savings of up to 20%. Awareness campaigns aimed at patients appear to be effective. Twenty-eight-day repeat prescribing has resulted in year-on-year reductions on the quantity of medication issued per prescription item to reach an average prescription length of 40 days in 2008. The increasing availability of generic medications has seen significant reductions in net ingredient costs. Nearly two-thirds of prescriptions are now issued as generics, with an average net ingredient cost of £3.83. Pharmacy charges to dispense a prescription item in 2008 averaged £1.81, so that pharmacy charges make up around one-third of the cost of most prescription items dispensed. If all 842.5 million prescription items issued by the NHS in England in 2008 had been 28-day repeat-dispensing items, this would have added a projected £700 million to the actual pharmacy costs of around £1.5 billion. Conclusions Unnecessary spending on pharmacy charges has the potential to outstrip the estimated cost of medicines wastage in the UK. The cost-effectiveness of restricted prescription lengths for the cheaper, mostly generic medications merits an urgent re-examination. [source] Administrative claims data analysis of nurse practitioner prescribing for older adultsJOURNAL OF ADVANCED NURSING, Issue 10 2009Andrea L. Murphy Abstract Title.,Administrative claims data analysis of nurse practitioner prescribing for older adults. Aim., This paper is a report of a study to identify the patterns of prescribing by primary health care nurse practitioners for a cohort of older adults. Background., The older adult population is known to receive complex pharmacotherapy. Monitoring prescribing to older adults can inform quality improvement initiatives. In comparison to other countries, research examining nurse practitioner prescribing in Canada is limited. Nurse practitioner prescribing for older adults is relatively unexplored in the international literature. Although commonly used to study physician prescribing, few studies have used claims data from drug insurance programmes to investigate nurse practitioner prescribing. Method., Drug claims for prescriptions written by nurse practitioners from fiscal years 2004/05 to 2006/07 for beneficiaries of the Nova Scotia Seniors' Pharmacare programme were analysed. Data were retrieved and analysed in May 2008. Prescribing was described for each drug using the World Health Organization Anatomical Therapeutic Chemical code classification system by usage and costs for each fiscal year. Results., Antimicrobials and non-steroidal anti-inflammatory drugs consistently represented the top ranked groups for prescription volume and cost. Over the three fiscal years, antimicrobial prescription rates declined relative to rates of other groups of medications. Prescription volume per nurse doubled and cost per prescription increased by approximately 20%. Conclusion., Prescription claims data can be used to characterize the prescribing trends of nurse practitioners. Research linking patient characteristics, including diagnoses, to prescriptions is needed to assess prescribing quality. Some potential areas of improvement were identified with antimicrobial and non-steroidal anti-inflammatory selection. [source] Antimicrobial prescribing trends in primary care: implications for health policy in Bahrain,,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2008Khalid A. J. Al Khaja PhD Abstract Purpose To evaluate antimicrobial prescribing pattern by primary care physicians. Methods A nation-wide, retrospective, multi-centric prescription-audit was carried out in primary care health centres in Bahrain. Results Systemic antimicrobials ranked the fourth most common class of drugs prescribed. Amoxycillin, cephalexin, erythromycin, ciprofloxacin and cotrimoxazole were prescribed by general practitioners (GPs) more often than by family physicians (FPs) (p,<,0.05). With respect to prescribing of other antimicrobials and anthelmintic mebendazole, the differences between GPs and FPs were nonsignificant. Seventy-seven per cent of systemic antimicrobials prescribed were for respiratory tract infections (RTIs). Topical antimicrobial preparations for ear and eye infections were prescribed by GPs in a rate significantly higher than by FPs (p,<,0.05); of these, chloramphenicol and Locacorten vioform® (flumethasone,+, clioquinol) ear drops and sulphacetamide eye drops were more often prescribed by GPs (p,<,0.05). There were no significant differences in prescribing between GPs and FPs as regards topical antimicrobials used for oropharyngeal, skin and vulvovaginal infections. Conclusion Antimicrobials were extensively used in primary care, mainly for treating RTIs. The general practitioners were more avid prescribers of antimicrobials compared to the FPs. Rational use of antimicrobials in primary care should be encouraged and the reasons for the observed differences in prescribing of antimicrobials between the GPs and FPs need further evaluation. Copyright © 2008 John Wiley & Sons, Ltd. [source] Changing patterns of antiepileptic drug use in pregnant Australian womenACTA NEUROLOGICA SCANDINAVICA, Issue 2 2010F. J. E. Vajda Vajda FJE, Hollingworth S, Graham J, Hitchcock AA, O'Brien TJ, Lander CM, Eadie MJ. Changing patterns of antiepileptic drug use in pregnant Australian women. Acta Neurol Scand: 2010: 121: 89,93. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objective,,, To trace the pattern of antiepileptic drug (AED) use in pregnant Australian women annually from 1999 to 2007, and correlate it with the pattern of AED use in the wider community. Methods,,, Analysis of data from the Australian Register of AEDs in Pregnancy, related to Australian population data for AED prescriptions. Results,,, Over the study period, prescribing of carbamazepine, phenytoin and valproate for pregnant women decreased, and prescribing of lamotrigine, topiramate and levetiracetam increased. These changes tended to parallel prescribing trends in the wider community, except for valproate, whose prescribing in the overall community increased as its prescribing, and its dosage prescribed, decreased in pregnancy. Concomitant with this, there was a trend towards fewer births of foetuses with abnormalities. Conclusions,,, While otherwise following national AED prescribing trends, Australian prescribers are reducing the use and dose of valproate in pregnant women, likely in recognition of the teratogenic hazards of this drug. [source] Declining Antibiotic Prescriptions for Upper Respiratory Infections, 1993,2004ACADEMIC EMERGENCY MEDICINE, Issue 4 2007Stefan G. Vanderweil BA Abstract Objectives: To examine antibiotic prescribing trends for U.S. emergency department (ED) visits with upper respiratory tract infections (URIs) between 1993 and 2004. Methods: Data were compiled from the National Hospital Ambulatory Medical Care Survey (NHAMCS). URI visits were identified by using ICD-9-CM code 465.9, whereas antibiotics were identified using the National Drug Code Directory class Antimicrobials. A multivariate logistic regression model revealed sociodemographic and geographic factors that were independently associated with receipt of an antibiotic prescription for URIs. Results: There were approximately 23.4 million ED visits diagnosed as URIs between 1993 and 2004. Although the proportion of URI diagnoses remained relatively stable (p trend = 0.26), a significant decrease in provision of antibiotic prescriptions for URIs occurred during this 12-year period, from a maximum of 55% in 1993, to a minimum of 35% in 2004. Patients who were prescribed antibiotics were more likely to be white than African American and to have been treated in EDs located in the southern United States. Conclusions: Antibiotic prescribing for URIs continues to decrease, a favorable trend that suggests that national efforts to reduce inappropriate antibiotic usage are having some success. Nevertheless, the frequency of antibiotic treatment for URI in the ED remains high (35%). Future efforts to reduce inappropriate antibiotic prescribing may focus on patients and physicians in southern U.S. EDs. Additional work is needed to address continued evidence of race-related disparities in care. [source] | ||||||||||