Prescription Patterns (prescription + pattern)

Distribution by Scientific Domains


Selected Abstracts


Prescription pattern of codeine for non-malignant pain: a pharmacoepidemiological study from the Norwegian Prescription Database

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2009
O. M. S. FREDHEIM
Background: Opioid prescription for pain relief is increasing. Codeine is the dominating opioid in several European countries, with Norway being among the highest codeine users. Aim: To determine whether codeine is primarily used for acute pain or whether there is a prescription pattern indicating problematic opioid use. Methods: All pharmacies in Norway are obliged to submit data electronically to the Norwegian Prescription Database at the Norwegian Institute of Public Health on all dispensed prescriptions. Because all prescriptions are identified with a unique person identifier, it is possible to identify all prescriptions to one subject. All subjects who had prescription(s) of codeine dispensed to them in 2004, 2005 or 2006 are included in the study. Results: 385 190 Norwegian persons had at least one prescription of codeine dispensed to them due to non-cancer pain in 2005, corresponding to a 1-year periodic prevalence of 8.3%. 223 778 (58%) received only one prescription in 2005, 121 025 (31%) received more than one prescription but <120 defined daily doses (DDDs), 30 939 (8%) received between 120 and 365 DDDs, 7661 (2%) between 365 and 730 DDDs, while only 1787 (0.5%) exceeded the maximum recommended dose of 730 DDDs. In the latter group, co-medication with benzodiazepines (65%) and carisoprodol (45%) was prevalent. Conclusion: About one in 10 adult persons in Norway were dispensed codeine in 2005. A majority (58%) received codeine only once, most likely for acute pain, whereas a small minority (0.5%) had a prescription pattern indicating problematic opioid use. [source]


Prescribing patterns of antiparkinsonian agents in Europe,

MOVEMENT DISORDERS, Issue 8 2010
Mário Miguel Rosa MD
Abstract In the 1990s, previous knowledge and randomized controlled trials supported the establishment of today's therapeutic recommendations in Parkinson's disease (PD). Scientific evidence allows different options for the treatment of PD. Patterns of use of antiparkinsonian agents (APA) across European countries may thus reflect these options. We wanted to describe patterns of use of APA in Europe and characterize the changes in prescription habits between 2003 and 2007. We investigated APA outpatient sales in 26 European countries where all commercially available APA were studied. Data for molecules and brand names were collected through IMS Health. Treatment per 1000 inhabitants daily (DID) was obtained from the WHO defined daily dose. Prescription pattern changes were evaluated by market share. Prescription patterns varied widely. In most countries, levodopa/dopamine agonists accounted for half of the drug use; whereas in others, anticholinergics, MAO inhibitors and amantadine prevailed. The greatest increase occurred with monoamine oxidase inhibitors and levodopa. There was an increase in dopamine agonists and a decrease in anticholinergics. For a 6.8% dose consume increase, there was a 41.1% sales increase (in euros). We showed an increase in the consumption of APA over 5 years. There was significant heterogeneity in the use of APA in Europe, suggesting differences in drug treatment. Costs of medication increased more than did dose consume, implying an increase in the cost of individual patient treatment. Published evidence does not explain the observed differences in the prescribing of APA. © 2010 Movement Disorder Society [source]


Prescribing antipsychotic drugs for inpatients with schizophrenia in Asia: Comparison of REAP-2001 and REAP-2004 studies

ASIA-PACIFIC PSYCHIATRY, Issue 2 2010
Mian-Yoon Chong MD PhD FRCPsych
Abstract Introduction: This international collaborative study aimed to investigate the trend and change in prescription patterns of antipsychotic drugs for inpatient schizophrenia in Asia by comparing two surveys in 2001 and 2004. Methods: Prescription patterns of inpatient schizophrenia in China, Hong Kong, Japan, Korea, Singapore and Taiwan were surveyed in July of 2001 and 2004 using a standardized protocol. Patients' social and clinical characteristics, psychiatric symptoms, course of illness and adverse effects of medications were systematically assessed and recorded. Prescription patterns of antipsychotic drugs were compared and analyzed. Results: Altogether, 4535 patients were surveyed. There were no significant differences in their demographic characteristics between 2001 and 2004. Compared with 2001, a significant increase in the use of second-generation antipsychotics (SGA) (from 45.5% to 64.7%) with reciprocal decreasing use of first-generation antipsychotics was found in 2004. The trend was unanimously seen across these Asian countries and among those prescribed with monotherapy or polypharmacy. The proportion using monotherapy significantly increased, from 52.7% in 2001 to 61.1% in 2004. There was a tendency of using a lower dosage of antipsychotic medications and a less concomitant use of anti-Parkinson drugs. Discussion: The present study showed a trend of increasing use of SGA among Asian countries. Except for Japan and Singapore, a relatively low use of antipsychotic polypharmacy was generally found. The increasing use of SGA and policy changes reduced the mean duration of admission days. With increasing awareness of consumers and continuing education for psychiatrists, the trend is expected to continue. [source]


Quetiapine indication shift in the elderly: diagnosis and dosage in 208 psychogeriatric patients from 2000 to 2006

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2007
Lorenz Hilwerling
Abstract Rationale Quetiapine was approved in Germany as an atypical antipsychotic for treatment of schizophrenia in 2000, followed by the approval as an antipsychotic for treatment of bipolar mania in 2003. The approval of quetiapine for treatment of bipolar depression is expected. We hypothesized that the psychogeriatric prescription pattern for quetiapine shifts from the psychotic to the affective spectrum. Methods Retrospectively we screened discharge reports of all geriatric inpatients of the psychiatric department of the Ruhr-University of Bochum in the period from January 2001 until March 2006 and identified 208 individual patients aged over 60 years, who had received quetiapine as final medication. Age, gender, daily drug dose, year of treatment and diagnosis (according to ICD-10) were recorded and analyzed. Results Over the six-year time span, the proportion of affective disorders (F3) as indication for quetiapine in the elderly increased, whereas the proportion of dementia (F0) as indication for quetiapine decreased significantly. The proportion of schizophrenic disorders (F2) treated with quetiapine did not change significantly. Discussion Since the decision of the German Federal Court in 2002 ,off label' use goes to the expenses of the prescriber. So the decrease of quetiapine in dementia is probably due to its ,off label' status in dementia. The psychogeriatric indication shift for quetiapine towards affective disorders could be the consequence of good clinical experiences with the drug and growing evidence for its antidepressant effect. Conclusion In addition to controlled pharmacological trials prospective clinical research is needed to evaluate the prescription attitudes of clinicians. Copyright © 2006 John Wiley & Sons, Ltd. [source]


Prescription pattern of codeine for non-malignant pain: a pharmacoepidemiological study from the Norwegian Prescription Database

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2009
O. M. S. FREDHEIM
Background: Opioid prescription for pain relief is increasing. Codeine is the dominating opioid in several European countries, with Norway being among the highest codeine users. Aim: To determine whether codeine is primarily used for acute pain or whether there is a prescription pattern indicating problematic opioid use. Methods: All pharmacies in Norway are obliged to submit data electronically to the Norwegian Prescription Database at the Norwegian Institute of Public Health on all dispensed prescriptions. Because all prescriptions are identified with a unique person identifier, it is possible to identify all prescriptions to one subject. All subjects who had prescription(s) of codeine dispensed to them in 2004, 2005 or 2006 are included in the study. Results: 385 190 Norwegian persons had at least one prescription of codeine dispensed to them due to non-cancer pain in 2005, corresponding to a 1-year periodic prevalence of 8.3%. 223 778 (58%) received only one prescription in 2005, 121 025 (31%) received more than one prescription but <120 defined daily doses (DDDs), 30 939 (8%) received between 120 and 365 DDDs, 7661 (2%) between 365 and 730 DDDs, while only 1787 (0.5%) exceeded the maximum recommended dose of 730 DDDs. In the latter group, co-medication with benzodiazepines (65%) and carisoprodol (45%) was prevalent. Conclusion: About one in 10 adult persons in Norway were dispensed codeine in 2005. A majority (58%) received codeine only once, most likely for acute pain, whereas a small minority (0.5%) had a prescription pattern indicating problematic opioid use. [source]


Changing GPs' prescription patterns through guidelines and feedback.

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 6 2007
Intervention study
Abstract Purpose To investigate whether and how a multi-dimensional intervention including clinical guidelines on the choice of medical treatment in the primary and the secondary health care sector, and individual feedback to general practices about their own and other practices' prescription patterns in five Anatomical Therapeutic Chemical classification system (ATC)-groups was followed by changes in the practices' prescription pattern. Methods Prospective historical registry study and a questionnaire study of GPs' self-reported use of guidelines and feedback. Results In every ATC-group the number of prescribed defined daily doses (DDDs) kept growing after the intervention, while potential savings by DDD decreased. Individual practices' changes in the prescription pattern differed by ATC-group and practices with high potential savings/DDD before the intervention showed the greatest relative reduction in potential savings/DDD. The county's average cost/DDD for the five ATC-groups declined from above the Danish average before the intervention to a level below the average cost/DDD after the intervention. In the questionnaire study (response rate: 79%), 69% of respondents had read the guidelines and 78% reported that the feedback influenced their prescription of drugs. Conclusions The observed changes in drug costs and potential savings were not due to volume effects but a combination of price effects, including generic substitution and choice of less expensive analogues, demonstrating that it is possible to change GPs' prescription patterns without interfering with patients' access to treatment or with GPs' clinical freedom.' Copyright © 2007 John Wiley & Sons, Ltd. [source]


International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: Analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2007
NAOKI UCHIDA md
Abstract The purpose of the present study was to review the prescription patterns of antidepressants in different countries in East Asia. The survey was conducted in China, Japan, Korea, Singapore and Taiwan from October 2003 to March 2004 using the unified research protocol and questionnaire. Twenty teaching hospitals and major psychiatric hospitals participated and a total of 1898 patients receiving antidepressants were analyzed. The survey provided a number of interesting characteristics on the prescription patterns of antidepressant in East Asia. Out of 56 antidepressants listed in the Anatomical Therapeutic Chemical Classification (ATC) index by the World Health Organization (WHO) Collaborating Center for Drug Statistics Methodology (Oslo), only 26 antidepressants were prescribed in participating countries in East Asia. On average 38.4% of prescriptions of antidepressants were for patients with diagnoses other than depressive disorders. The availability and commonly prescribed antidepressants varied greatly by country. The selective serotonin re-uptake inhibitors (SSRI) and other newer antidepressants were prescribed in approximately 77.0% of all cases. At the time of the survey, only two SSRI medications were available in Japan. However, five types of SSRI were available and were often prescribed in Korea. [source]


The International Quotidian Dialysis Registry: Annual report 2008

HEMODIALYSIS INTERNATIONAL, Issue 3 2008
Gihad E. NESRALLAH
Abstract Alternative hemodialysis (HD) schedules, including short-daily and nocturnal HD, continue to proliferate, with the hope of offering improved patient outcomes. Three nights per week and every other night, nocturnal HD are now being provided to more patients worldwide, both at home and in-center. However, alternative HD schedules are still experimental in most centers, and studies establishing the efficacy of these therapies with respect to major clinical outcomes are needed. Endorsed by the National Institutes of Health, the International Quotidian Dialysis Registry is an international collaboration that was established in 2002 to prospectively study large numbers of patients treated with alternate HD schedules. The Registry will ultimately allow alternate HD modalities to be compared to conventional thrice-weekly HD with respect to clinical endpoints, including mortality, using a prospective cohort study. To date, the Registry has enrolled 182, 1193, and 740 subjects from Canada, the United States, and Australia, respectively. This report is the fourth annual update and describes recruitment progress, baseline characteristics of enrolled patients, and worldwide prescription patterns. [source]


Clinical correlates of clozapine prescription for schizophrenia in China

HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 1 2007
Yu-tao Xiang
Abstract Aims Few studies have investigated the prescription patterns of clozapine in outpatients with schizophrenia in China. It is an important issue due to clozapine's high efficacy and potentially fatal side effect profile. This study examined the use of clozapine and its correlates in China. Methods Three hundred ninety-eight clinically stable outpatients with schizophrenia were randomly selected and interviewed in Hong Kong (HK) and Beijing (BJ). Assessment instruments included the Structured Clinical Interview for DSM-IV, Brief Psychiatric Rating Scale, Simpson and Angus Scale of Extrapyramidal Symptoms, Barnes Akathisia Rating Scale and the Hong Kong and Mainland China World Health Organization Quality of Life Schedule-Brief version. Assessments were performed by the same investigator in both sites. Results Clozapine was prescribed to 15.6% of (n,=,62) patients. There was a wide inter-site variation between HK and BJ. Use of clozapine was associated with age, age at onset, extrapyramidal side effects (EPS), having health insurance, use of depot and typical antipsychotic and anticholinergic drugs and benzodiazepines as well as history of suicidal attempts. On multiple logistic regression analysis, the number of hospitalizations, site (HK vs. BJ), use of typical antipsychotics, polypharmacy and co-prescription with anticholinergics were significantly associated with the prescription of clozapine. No significant differences were found between the clozapine and non-clozapine groups with regard to any of the quality of life domains. Conclusion A combination of economical and clinical factors, health policies and the characteristics of the treatment settings plays important roles in determining clozapine use. Clozapine appears to have little significant influence on quality of life in clinical stable Chinese patients with schizophrenia. Copyright © 2007 John Wiley & Sons, Ltd. [source]


Changing GPs' prescription patterns through guidelines and feedback.

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 6 2007
Intervention study
Abstract Purpose To investigate whether and how a multi-dimensional intervention including clinical guidelines on the choice of medical treatment in the primary and the secondary health care sector, and individual feedback to general practices about their own and other practices' prescription patterns in five Anatomical Therapeutic Chemical classification system (ATC)-groups was followed by changes in the practices' prescription pattern. Methods Prospective historical registry study and a questionnaire study of GPs' self-reported use of guidelines and feedback. Results In every ATC-group the number of prescribed defined daily doses (DDDs) kept growing after the intervention, while potential savings by DDD decreased. Individual practices' changes in the prescription pattern differed by ATC-group and practices with high potential savings/DDD before the intervention showed the greatest relative reduction in potential savings/DDD. The county's average cost/DDD for the five ATC-groups declined from above the Danish average before the intervention to a level below the average cost/DDD after the intervention. In the questionnaire study (response rate: 79%), 69% of respondents had read the guidelines and 78% reported that the feedback influenced their prescription of drugs. Conclusions The observed changes in drug costs and potential savings were not due to volume effects but a combination of price effects, including generic substitution and choice of less expensive analogues, demonstrating that it is possible to change GPs' prescription patterns without interfering with patients' access to treatment or with GPs' clinical freedom.' Copyright © 2007 John Wiley & Sons, Ltd. [source]


International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: Analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2007
NAOKI UCHIDA md
Abstract The purpose of the present study was to review the prescription patterns of antidepressants in different countries in East Asia. The survey was conducted in China, Japan, Korea, Singapore and Taiwan from October 2003 to March 2004 using the unified research protocol and questionnaire. Twenty teaching hospitals and major psychiatric hospitals participated and a total of 1898 patients receiving antidepressants were analyzed. The survey provided a number of interesting characteristics on the prescription patterns of antidepressant in East Asia. Out of 56 antidepressants listed in the Anatomical Therapeutic Chemical Classification (ATC) index by the World Health Organization (WHO) Collaborating Center for Drug Statistics Methodology (Oslo), only 26 antidepressants were prescribed in participating countries in East Asia. On average 38.4% of prescriptions of antidepressants were for patients with diagnoses other than depressive disorders. The availability and commonly prescribed antidepressants varied greatly by country. The selective serotonin re-uptake inhibitors (SSRI) and other newer antidepressants were prescribed in approximately 77.0% of all cases. At the time of the survey, only two SSRI medications were available in Japan. However, five types of SSRI were available and were often prescribed in Korea. [source]


Prescribing antipsychotic drugs for inpatients with schizophrenia in Asia: Comparison of REAP-2001 and REAP-2004 studies

ASIA-PACIFIC PSYCHIATRY, Issue 2 2010
Mian-Yoon Chong MD PhD FRCPsych
Abstract Introduction: This international collaborative study aimed to investigate the trend and change in prescription patterns of antipsychotic drugs for inpatient schizophrenia in Asia by comparing two surveys in 2001 and 2004. Methods: Prescription patterns of inpatient schizophrenia in China, Hong Kong, Japan, Korea, Singapore and Taiwan were surveyed in July of 2001 and 2004 using a standardized protocol. Patients' social and clinical characteristics, psychiatric symptoms, course of illness and adverse effects of medications were systematically assessed and recorded. Prescription patterns of antipsychotic drugs were compared and analyzed. Results: Altogether, 4535 patients were surveyed. There were no significant differences in their demographic characteristics between 2001 and 2004. Compared with 2001, a significant increase in the use of second-generation antipsychotics (SGA) (from 45.5% to 64.7%) with reciprocal decreasing use of first-generation antipsychotics was found in 2004. The trend was unanimously seen across these Asian countries and among those prescribed with monotherapy or polypharmacy. The proportion using monotherapy significantly increased, from 52.7% in 2001 to 61.1% in 2004. There was a tendency of using a lower dosage of antipsychotic medications and a less concomitant use of anti-Parkinson drugs. Discussion: The present study showed a trend of increasing use of SGA among Asian countries. Except for Japan and Singapore, a relatively low use of antipsychotic polypharmacy was generally found. The increasing use of SGA and policy changes reduced the mean duration of admission days. With increasing awareness of consumers and continuing education for psychiatrists, the trend is expected to continue. [source]


National Trends in Emergency Department Antibiotic Prescribing for Children with Acute Otitis Media, 1996,2005

ACADEMIC EMERGENCY MEDICINE, Issue 12 2007
Thomas Fischer MD
Objectives Withholding antibiotics in nontoxic children with acute otitis media (AOM) is now recommended to reduce bacterial resistance rates. Using the National Hospital Ambulatory Medical Care Survey (NHAMCS), the authors describe the national trends for prescribing antibiotics in children with AOM presenting to emergency departments (EDs) in the United States over the past decade. The authors hypothesized that the rates of prescribing antibiotics would decline over time. Methods This was a retrospective study of NHAMCS databases. A national sampling of ED visits for 1996,2005 was used to identify trends in ED prescription of antibiotics to patients with AOM. The National Drug Code Directory Drug Classes were used to identify type of antibiotic prescribed. Frequency and type of antibiotic prescription patterns over time were evaluated. Results There were 2.6 million and 2.1 million ED visits for AOM during the first and last years of the study. Children ages 2,12 years accounted for about 40% of all ED visits for AOM, with another 40% in the younger than 2 years age group and 20% in the older than 12 years of age group. During the first and last year of the study, 79.2% and 91.3% of the patients with AOM were prescribed antibiotics, respectively. There was a slight increasing trend in the proportion prescribed antibiotics over time (p = 0.02). The rates of use of antibiotics for AOM were similar in all three age groups. Conclusions There was a slight increase in the percentage of children with AOM who were prescribed antibiotics in the ED between 1996 and 2005. There was also no change in the patterns of prescribing antibiotics. [source]