National drug policies: the need for drug utilization studies

Aspire of the Drug Utilization Studies (DUS) is to appraise factors related to the prescribing, dispensing, administering and taking of medication, and it’s associated. Since the middle of twentieth century, interest in DUS has been escalating, first for market-only purposes, then for appraising the quality of medical prescription and comparing patterns of use of specific drugs. The scope of DUS is to evaluate the current state and future trends of drug usage, to estimate roughly disease pervasiveness, drug expenditures, aptness of prescriptions and adherence to evidence-based recommendations. The increasing magnitude of DUS as a valuable investigation resource in pharmacoepidemiology has been bridging it with other health allied areas, such as public health, rational use of drug, evidence based drug use, pharmacovigilance, pharmacoeconomics, eco-pharmacovigilance and pharmacogenetics.

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Review of Drug Utilization Studies in Neonatal Units: A Global Perspective

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165669 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5669 ◽

Cited By ~ 1

Author(s):

Asma Al-Turkait ◽

Lisa Szatkowski ◽

Imti Choonara ◽

Shalini Ojha

Keyword(s):

Drug Use ◽

Drug Utilization ◽

Antibiotic Use ◽

Global Perspective ◽

Use Patterns ◽

Rational Prescribing ◽

Drug Use Patterns ◽

General Drug ◽

The Usa ◽

Drug Utilization Studies

Rational prescribing is challenging in neonatology. Drug utilization studies help identify and define the problem. We performed a review of the literature on drug use in neonatal units and describe global variations. We searched databases (EMBASE, CINAHL and Medline) from inception to July 2020, screened studies and extracted relevant data (two reviewers). The search revealed 573 studies of which 84 were included. India (n = 14) and the USA (n = 13) reported the most. Data collection was prospective (n = 56) and retrospective (n = 26), mostly (n = 52) from one center only. Sixty studies described general drug use in 34 to 450,386 infants (median (IQR) 190 (91–767)) over a median (IQR) of 6 (3–18) months. Of the participants, 20–87% were preterm. The mean number of drugs per infant (range 11.1 to 1.7, pooled mean (SD) 4 (2.4)) was high with some reporting very high burden (≥30 drugs per infant in 8 studies). This was not associated with the proportion of preterm infants included. Antibiotics were the most frequently used drug. Drug use patterns were generally uniform with some variation in antibiotic use and more use of phenobarbitone in Asia. This study provides a global perspective on drug utilization in neonates and highlights the need for better quality information to assess rational prescribing.

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Agreement between different recall periods in drug utilization studies

Revista Brasileira de Epidemiologia ◽

10.1590/1980-5497201700020012 ◽

2017 ◽

Vol 20 (2) ◽

pp. 324-334 ◽

Cited By ~ 4

Author(s):

Cassia Garcia Moraes ◽

Sotero Serrate Mengue ◽

Tatiane da Silva Dal Pizzol

Keyword(s):

Drug Use ◽

Drug Utilization ◽

Recall Period ◽

Percent Agreement ◽

Drug Utilization Studies ◽

24 Hour Recall ◽

High Level ◽

Continuous Use ◽

First Interview ◽

Level Of Agreement

ABSTRACT: Objective: To assess the agreement between three recall periods for self-reported drug use using a 24-hour recall period as reference. Methods: Participants were allocated into three groups with different recall periods of 7, 14 and 30 days and were interviewed at two different times. A 24-hour recall questionnaire was answered during the first interview, and a questionnaire on drug use over the different recall periods tested was answered during the second interview. The agreement between the questionnaires was evaluated using percent agreement and kappa. Results: For continuous drugs, percent agreement varied between 92 and 99% and kappa varied between 0.71 and 0.97 for three periods tested. For drugs of occasional use, percent agreement varied between 63 and 81% and kappa varied between 0.27 and 0.52. The prevalence of drugs, particularly those of occasional use, increases with time. Conclusions: The high level of agreement between the three recall periods suggests that all of them are valid for the investigation of drugs of continuous use.

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Ethical Requirements for the Conduct of Drug Utilization Studies in Latin America: A Cross-Sectional Survey

Value in Health ◽

10.1016/j.jval.2017.08.2802 ◽

2017 ◽

Vol 20 (9) ◽

pp. A909

Author(s):

A Bergamasco ◽

G Castillon ◽

Y Moride

Keyword(s):

Latin America ◽

Drug Utilization ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Drug Utilization Studies

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Barriers and facilitators to adherence to national drug policies on antibiotic prescribing and dispensing in Bangladesh

Journal of Pharmaceutical Policy and Practice ◽

10.1186/s40545-021-00342-7 ◽

2021 ◽

Vol 14 (S1) ◽

Author(s):

Fosiul Alam Nizame ◽

Dewan Muhammad Shoaib ◽

Emily K. Rousham ◽

Salma Akter ◽

Mohammad Aminul Islam ◽

...

Keyword(s):

Drug Policy ◽

Group Discussion ◽

National Policy ◽

Barriers And Facilitators ◽

Drug Shop ◽

Antibiotic Prescribing ◽

National Drug ◽

National Drug Policy ◽

Drug Policies ◽

The Government

Abstract Background The National Drug Policy in Bangladesh prohibits the sale and distribution of antibiotics without prescription from a registered physician. Compliance with this policy is poor; prescribing antibiotics by unqualified practitioners is common and over-the-counter dispensing widespread. In Bangladesh, unqualified practitioners such as drug shop operators are a major source of healthcare for the poor and disadvantaged. This paper reports on policy awareness among drug shop operators and their customers and identifies current dispensing practices, barriers and facilitators to policy adherence. Methods We conducted a qualitative study in rural and urban Bangladesh from June 2019 to August 2020. This included co-design workshops (n = 4) and in-depth interviews (n = 24) with drug shop operators and customers/household members, key informant interviews (n = 12) with key personnel involved in aspects of the antibiotic supply chain including pharmaceutical company representatives, and model drug shop operators; and a group discussion with stakeholders representing key actors in informal market systems namely: representatives from the government, private sector, not-for-profit sector and membership organizations. Results Barriers to policy compliance among drug shop operators included limited knowledge of government drug policies, or the government-led Bangladesh Pharmacy Model Initiative (BPMI), a national guideline piloted to regulate drug sales. Drug shop operators had no clear knowledge of different antibiotic generations, how and for what diseases antibiotics work contributing to inappropriate antibiotic dispensing. Nonetheless, drug shop operators wanted the right to prescribe antibiotics based on having completed related training. Drug shop customers cited poor healthcare facilities and inadequate numbers of attending physician as a barrier to obtaining prescriptions and they described difficulties differentiating between qualified and unqualified providers. Conclusion Awareness of the National Drug Policy and the BPMI was limited among urban and rural drug shop operators. Poor antibiotic prescribing practice is additionally hampered by a shortage of qualified physicians; cultural and economic barriers to accessing qualified physicians, and poor implementation of regulations. Increasing qualified physician access and increasing training and certification of drug shop operators could improve the alignment of practices with national policy.

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