scholarly journals Determinants of use of gonadotropin formulations to treat female infertility in an Italian region

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Rosa ◽  
V Belleudi ◽  
A Addis ◽  
A Ciardulli ◽  
A Pacchiarotti ◽  
...  
Keyword(s):  
General Practitioners ◽  
Census Data ◽  
Time Window ◽  
Italian Region ◽  
Lazio Region ◽  
Use Patterns ◽  
Fertility Drugs ◽  
Drug Use Patterns ◽  
Economic Position ◽  
Over Time

Abstract Background Gonadotropins (Gona) are commonly used for infertility treatment in women. They are available as urinary purified extracts (u-Gona) and recombinants (r-Gona). Objectives:We investigated if socio-demographic characteristics of treated women, year of dispensation and type of prescriber may play a role in the choice of a treatment with respect to the other. Methods From administrative healthcare databases, we collected claims of Gona for women, aged 18-45, enrolled in the health care system in the year preceding the first prescription (years 2009-2018). Treatment cycles were defined as a 21-day mobile time window. We identified three groups: u-Gona, r-Gona and treatment with both formulations (m-Gona). To identify determinants, we linked women with the socio-economic position (SEP), a composite deprivation index, based on the 2011 Italian Census data,categorized in 4 levels (high, medium-high, medium-low, low). We associated prescriptions with the type of prescriber, distinguishing between specialists and general practitioners. Results We retrieved 38,598 Gona treatment cycles prescribed to 23,412 women and distributed between formulations as follows: r-Gona 47.4%, u-Gona 26.3% and m-Gona 26.3%. The median age was 38 years for r-Gona and u-Gona, 39 for m-Gona. Comparing the type of prescriber, specialists were more likely to prescribe u-Gona instead of r-Gona (OR: 2.14; 95%CI: 2.02-2.27) than general practitioners. No relation was found between SEP and Gona formulations, except for patients with the highest level who were more likely to be prescribed with r-Gona instead of u-Gona (OR: 1.12; 95%CI: 1.03-1.21). Time trends showed that treatment choices changed over time. Conclusions In the Lazio region, the choice of gonadotropin formulations varied over time and was found to be related to the prescriber and partly to socio-economic position. An analysis of outcomes related to different treatments is under way. Key messages More and more women are using artificial insemination techniques; it is important to monitor fertility drug use patterns and determinants of the choice of a treatment. The use of fertility drugs is a multifactorial phenomenon and a matter of public health interest.

scholarly journals Biosimilar formulations of gonadotropins in a central Italian region: use patterns and time trends

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Rosa ◽  
V Belleudi ◽  
A Addis ◽  
A Ciardulli ◽  
A Pacchiarotti ◽  
...  
Keyword(s):  
General Practitioners ◽  
Time Trends ◽  
Special Focus ◽  
Local Health ◽  
Italian Region ◽  
Lazio Region ◽  
Use Patterns ◽  
Follitropin Alfa ◽  
Drug Use Patterns ◽  
Temporal And Spatial

Abstract Background Gonadotropins (Gonas) are hormones that play a central role in the follicular growth of women but also useful in male infertility. Gonas used for infertility treatment in women are available as urinary extracts or recombinants. In 2015, the first biosimilar of follitropin alfa was authorised. Objectives We aimed to evaluate use patterns, temporal and spatial variations of Gonas biosimilar formulations in an central Italian region. Methods From administrative healthcare databases of Lazio region, we extracted prescriptions that have occurred over the years 2015-2019. Gona's use was grouped as treatment with urinary (u) and recombinant (r). Special focus was made on biosimilar r-Gona. Use patterns were investigated with respect to characteristics of the patients treated, time trends, differences among local health units and type of prescribing physician. Results For the study period, we retrieved 136,333 Gona dispensations for 22,325 patients. The 10,927 r-Gona biosimilar dispensations (8.01% of all claims, of which 99.43% Bemfola®, and 0.57% Ovaleap®), were mostly referred to women, aged 18-45 years, (87.11% of all patients). Median age was 37 years for women, 38 for men. Since its authorisation, biosimilar r-Gona steadily gained market from 2015 (0,4% of claims) to 2017 (22,7%) followed by a decrease in 2019 (4,3%). Biosimilars claims are more frequent in treating men (10,8%) than women (6,1%). Most biosimilar prescriptions were issued by general practitioners (86.4%), followed by specialists (10.2%) and others. Biosimilar use patterns varied between different local health units (IQR 3.2%-8,5%). Conclusions In clinical pratice, r-Gona biosimilar dispensation, 8,8% of Gonas. are mostly prescribed from general practitioners and are proportionately more targeted at men than women. Further investigation is needed. Key messages More and more men and women are using artificial insemination techniques; it is important to monitor fertility drug use patterns. In times of savings for the economic system,the use of the biosimilar drugs is of increasing interest.

Increasing prevalence of prescription opiate misuse over time among rural probationers

2007 ◽  
Vol 3 (2) ◽  
pp. 107 ◽  
Author(s):  
Jennifer R. Havens, PhD, MPH ◽  
Carrie B. Oser, PhD ◽  
Carl G. Leukefeld, DSW
Keyword(s):  
Public Health ◽  
Prescription Drugs ◽  
Rural Areas ◽  
Demographic Characteristics ◽  
Public Health Issue ◽  
Community Based ◽  
Major Public Health Issue ◽  
Use Patterns ◽  
Drug Use Patterns ◽  
Over Time

Prescription opiate misuse is a major public health issue, especially in rural areas. The purpose of this analysis was to examine trends in prescription opiate misuse over time in a cohort of community-based rural proba-tioners. Participants (N = 800), recruited over a four-year period, were divided into cohorts according to the year in which they were interviewed. Prescription opiate misuse increased significantly between 2001 and2004 (p < 0.001). After adjustment for changes in demographic characteristics of the cohorts, misuse of prescription opiates was still significantly greater in 2004 compared with 2001. These data suggest changes in drug use patterns among community-based rural probationers from street to prescription drugs. Implications of the findings are discussed.

Drug Use Patterns Over Time Among HIV-Seropositive and HIV-Seronegative Women: The HER Study Experience

2003 ◽  
Vol 33 (4) ◽  
pp. 500-505 ◽  
Author(s):  
Grace E. Macalino ◽  
Hyejin Ko ◽  
David D. Celentano ◽  
Joseph W. Hogan ◽  
Ellie E. Schoenbaum ◽  
...  
Keyword(s):  
Drug Use ◽  
Use Patterns ◽  
Drug Use Patterns ◽  
Study Experience ◽  
Hiv Seropositive ◽  
Over Time

scholarly journals Predictors of historical change in drug treatment coverage among people who inject drugs in 90 large metropolitan areas in the USA, 1993–2007

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Barbara Tempalski ◽  
Leslie D. Williams ◽  
Brooke S. West ◽  
Hannah L. F. Cooper ◽  
Stephanie Beane ◽  
...  
Keyword(s):  
Public Health ◽  
Drug Treatment ◽  
Resource Availability ◽  
People Who Inject Drugs ◽  
Census Data ◽  
Poverty Rate ◽  
Community Action ◽  
Historical Change ◽  
Treatment Coverage ◽  
Over Time

Abstract Background Adequate access to effective treatment and medication assisted therapies for opioid dependence has led to improved antiretroviral therapy adherence and decreases in morbidity among people who inject drugs (PWID), and can also address a broad range of social and public health problems. However, even with the success of syringe service programs and opioid substitution programs in European countries (and others) the US remains historically low in terms of coverage and access with regard to these programs. This manuscript investigates predictors of historical change in drug treatment coverage for PWID in 90 US metropolitan statistical areas (MSAs) during 1993–2007, a period in which, overall coverage did not change. Methods Drug treatment coverage was measured as the number of PWID in drug treatment, as calculated by treatment entry and census data, divided by numbers of PWID in each MSA. Variables suggested by the Theory of Community Action (i.e., need, resource availability, institutional opposition, organized support, and service symbiosis) were analyzed using mixed-effects multivariate models within dependent variables lagged in time to study predictors of later change in coverage. Results Mean coverage was low in 1993 (6.7%; SD 3.7), and did not increase by 2007 (6.4%; SD 4.5). Multivariate results indicate that increases in baseline unemployment rate (β = 0.312; pseudo-p < 0.0002) predict significantly higher treatment coverage; baseline poverty rate (β = − 0.486; pseudo-p < 0.0001), and baseline size of public health and social work workforce (β = 0.425; pseudo-p < 0.0001) were predictors of later mean coverage levels, and baseline HIV prevalence among PWID predicted variation in treatment coverage trajectories over time (baseline HIV * Time: β = 0.039; pseudo-p < 0.001). Finally, increases in black/white poverty disparity from baseline predicted significantly higher treatment coverage in MSAs (β = 1.269; pseudo-p < 0.0001). Conclusions While harm reduction programs have historically been contested and difficult to implement in many US communities, and despite efforts to increase treatment coverage for PWID, coverage has not increased. Contrary to our hypothesis, epidemiologic need, seems not to be associated with change in treatment coverage over time. Resource availability and institutional opposition are important predictors of change over time in coverage. These findings suggest that new ways have to be found to increase drug treatment coverage in spite of economic changes and belt-tightening policy changes that will make this difficult.

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

2020 ◽  
Vol 17 (16) ◽  
pp. 5669 ◽  
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.

Personality, Motivation, and Adolescent Drug Use Patterns

1976 ◽  
Vol 5 (2) ◽  
pp. 17-23
Author(s):  
Samuel E. Krug ◽  
Thomas J. Henry
Keyword(s):  
Drug Use ◽  
Adolescent Drug Use ◽  
Use Patterns ◽  
Drug Use Patterns

scholarly journals Age-Cohort Differences in Longitudinal Associations Between the Rate of Internet Use and Memory Functioning

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 410-410
Author(s):  
Vineet Raichur ◽  
Lindsay Ryan ◽  
Richard Gonzalez ◽  
Jacqui Smith
Keyword(s):  
Older Adults ◽  
Episodic Memory ◽  
Cognitive Complexity ◽  
Internet Use ◽  
Age Groups ◽  
Word Recall ◽  
Use Patterns ◽  
Younger Age ◽  
Rate Of Increase ◽  
Over Time

Abstract Cross-sectional analyses of internet use patterns among older adults find that the rate of internet use is less with greater physical and memory difficulties. It is not clear, however, how age-cohorts differ in their internet use as physical and memory difficulties increase over time. In addition to factors such as increasing accessibility (cost) and social influences, the expansion and cognitive complexity of functions performed by the internet-enabled devices over time could influence internet use patterns. In this study, we investigate how the association between internet use and episodic memory difficulties over time varies between cohorts. We analyzed longitudinal data from the Health and Retirement Study (N = 15,703 in 2002; Aged 51 and older) between years 2002-2016 using mixed effects logistic regression models. Immediate and delayed word recall measures were used to assess episodic memory. Rate of internet use in the sample increased from 30% in 2002 to 53% in 2016. Rate of internet use among younger age groups was significantly higher in the baseline year. Younger age groups also showed a significantly higher rate of increase in internet use over time. In general, internet use decreased with episodic memory impairment. In addition to these effects, the effect of episodic memory on the rate of increase in internet use over time is lower in younger cohorts. These results indicate that younger cohorts of older adults are more likely to maintain internet use as they continue to age and therefore could better utilize technology for communication, social interactions and health interventions.

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