Implications of a defined daily dose fixed database for drug utilization research studies: The case of statins in Portugal

This paper in the series on pharmacoepidemiology describes the history, development, and present status of drug utilization activities. The various methodologies employed in drug utilization studies are evaluated and presented along with a listing of the principal drug databases available for drug utilization research. An analysis is presented comparing the validity of drug consumption rates based on individual patient usage or drug cost data as adopted in North America and the defined daily dose unit as developed in Europe. Drug utilization derives its importance in pharmacoepidemiology from the fact that it provides the methodological rigor for defining the denominator data needed in pharmacoepidemiological research.

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Unita di consumo dei farmaci e valutazioni farmacoeconomiche: uso e misuso di DDD e PDD

Farmeconomia Health economics and therapeutic pathways ◽

10.7175/fe.v3i4.756 ◽

2002 ◽

Vol 3 (4) ◽

pp. 209-222 ◽

Cited By ~ 1

Author(s):

Mario Eandi

Keyword(s):

Drug Utilization ◽

Pharmaceutical Expenditure ◽

Statistical Parameter ◽

Mean Value ◽

Measurement Unit ◽

Defined Daily Dose ◽

Daily Dose ◽

Utilization Patterns ◽

Measurement Units ◽

Drug Utilization Research

In pharmacoeconomical evaluations the quantification of drug utilization has to be done on the basis of measurement units that allow comparisons among series of longitudinal and transversal data. The most common techniques used for the analysis and the comparison of drug utilization patterns are based either on the Defined Daily Dose (DDD), a unit system proposed by WHO’s Drug Utilization Research Group, or on the Prescribed Daily Dose (PDD), a statistical parameter obtained from the analysis of drug prescriptions. This article illustrates the meaning of the main indicators of drug consumption that can be build with these techniques, underlining their utility and limitations. The DDD is the conventionally established theoretical mean daily dose of a drug, referred to a way of administration and to its main indication. It is, therefore, a mere technical measurement unit that cannot be interpreted as mean prescribed or consumed dose, and even less as recommended dose. The PDD, on the contrary, is not a measurement unit but a statistical mean value, that expresses the central tendency of the prescription variability in a defined setting. Starting from Italian data on the consumption of wide-spread antibiotics, the use and interpretation of various indicators based on the DDDs and PDDs are discussed. The parameters derived with the DDD technique are suitable for monitoring drug utilization and pharmaceutical expenditure. The PDD method is more direct, indicates the mean quantities actually prescribed and permits the estimation of the total dose consumed per therapeutic cycle and of other clinically relevant parameters, but requires the acquisition of more data than the other technique does. It is also important to remark the fact that both methods can’t be directly used for economical evaluations trying to assess the efficiency of resource allocation, as they are not correlated to the clinical outcomes of the therapy.

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Drug utilization research in a primary mental health service in Northeast of Brazil

Revista Portuguesa de Saúde Pública ◽

10.1016/j.rpsp.2012.03.001 ◽

2012 ◽

Vol 30 (1) ◽

pp. 55-61 ◽

Cited By ~ 1

Author(s):

Thais Teles de Souza ◽

Wellington Barros da Silva ◽

Jullyana de Souza Siqueira Quintans ◽

Alexandre Sherlley Casimiro Onofre ◽

Fabiana Botelho de Miranda Onofre ◽

...

Keyword(s):

Mental Health ◽

Mental Health Service ◽

Health Service ◽

Drug Utilization ◽

Utilization Research ◽

Drug Utilization Research

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Drug Utilization Research: Methods and Applications

The Canadian Journal of Hospital Pharmacy ◽

10.4212/cjhp.v70i4.1688 ◽

2017 ◽

Vol 70 (4) ◽

Author(s):

Heather Neville ◽

Shanna C Trenaman

Keyword(s):

Research Methods ◽

Drug Utilization ◽

Utilization Research ◽

Drug Utilization Research

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Study on drug utilization pattern and cost analysis among the psychiatric patients treated with various benzodiazepine derivatives

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20202193 ◽

2020 ◽

Vol 9 (6) ◽

pp. 975

Author(s):

Dhivya Govindasamy ◽

Gandhibabu Ramanathan ◽

Talari Venkata Siva Prasad ◽

Gopalakrishnan Ganesan

Keyword(s):

Cost Analysis ◽

Drug Utilization ◽

Alcohol Withdrawal ◽

Withdrawal Syndrome ◽

Psychiatric Patients ◽

Age Groups ◽

Alcohol Withdrawal Syndrome ◽

Defined Daily Dose ◽

Utilization Pattern ◽

Daily Dose

Background: The objective of the study was to assess drug utilization pattern and cost analysis among the psychiatric patients treated with various benzodiazepine derivatives.Methods: This observational study was conducted in department of psychiatric, RMMCH, Annamalai University. The study period was 6 months (November 2018 to April 2019). A total of 50 psychiatric patients were included.Results: A total 50 patients among them 64% (32) males and 36% (18) female, were included in the study. Most of the patient were between the age groups of 18-29 years (30%). The most common clinical condition treated with benzodiazepines were alcohol dependence syndrome/alcohol withdrawal syndrome/ alcohol related psychotic disorder (34%). The majority of patients were prescribed with clonazepam (66.67%). The defined daily dose (DDD) per 100 bed days of benzodiazepines were found to be 0.89. In this study the comparison of cost analysis for the drug used and it was found that lorazepam (122%) are most expensive followed by chlordiazepoxide (93.3%) and clonazepam (78.57%). The cheapest drug was nitrazepam (36.84%).Conclusions: The majority of the patient admitted in the psychiatric department were suffering from Alcohol depending syndrome/alcohol withdrawal syndrome. The most commonly prescribed benzodiazepine was clonazepam followed by lorazepam and least prescribed diazepam and nitrazepam based on defined daily dose concept.

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Drug utilization research: a review

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20190161 ◽

2019 ◽

Vol 8 (2) ◽

pp. 354

Author(s):

Dinesh Kumar Meena ◽

M. Jayanthi

Keyword(s):

Drug Use ◽

Drug Utilization ◽

Economic Consequences ◽

Health Policies ◽

Utilization Research ◽

Different Types ◽

Drug Utilization Research ◽

Ultimate Purpose ◽

Optimal Quality

Data from drug utilization research is an invaluable resource for all stake holders involved in drug and health policies. Drug utilization is “marketing, distribution, prescription and use of drugs in a society, with special emphasis on the resulting medical, social and economic consequences”. Research on drug utilization includes factors related to prescribing, dispensing, administering and intake of medication and its associated events. The ultimate purpose of drug utilization research is to estimate the optimal quality of drug therapy by identifying, documenting, analysing problems in drug utilization and monitoring the consequences. It encourages the prescribers to prescribe correct drug at appropriate dose and affordable price. It contributes to the knowledge of rational use of drugs in the society; whether the drug is being prescribed appropriately, whether the drug is taken in correct dosage, whether the drug is available at affordable price or misused. It provides valuable feedback about the rationality of the prescription to the doctors. It also assesses whether an intervention affects the drug use in the population by examining the outcomes of different types of intervention given to improve rationality in drug use. Drug utilization research can be qualitative or quantitative and can be done by various methods. This review highlights the understanding of various aspects, different designs and WHO guidelines for conducting drug utilization research.

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Community-Based Participatory Research and Drug Utilization Research to improve Childhood Diarrhea Case Management in Ujjain, India: A Cross Sectional Survey

10.20944/preprints201905.0109.v1 ◽

2019 ◽

Author(s):

Aditya Mathur ◽

Devendra Baghel ◽

Jitendra Jaat ◽

Vishal Diwan ◽

Ashish Pathak

Keyword(s):

Case Management ◽

Drug Utilization ◽

Health Care Providers ◽

Household Waste ◽

Care Providers ◽

Childhood Diarrhea ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Utilization Research ◽

Drug Utilization Research

Childhood diarrhea continues to be a major cause of under-five (U-5) mortality globally and in India. In this study, 1571 U-5 children residing in nine rural villages and four urban slums in Ujjain, India were included with the objective to use community participation and drug utilization research to improve diarrheal case management. The mean age was 2.08 years, with 297 (19%), children living in high diarrheal index households. Most mothers (70%) considered stale food, teething (62%) and hot weather (55%) as causes of diarrhea. Water, sanitation, and hygiene (WASH)-related characteristics revealed that most (93%) households had toilets, but only 23% children used them. The study identified ineffective household water treatment by filtration through cloth by most (93%) households and dumping of household waste on streets (89%). The results revealed low community awareness of correct causes of diarrhea (poor hand hygiene, 21%; littering around the household, 15%) and of correct diarrhea treatment (oral rehydration solution [ORS] and zinc use, 29% and 11%, respectively) and a high antibiotic prescription rate by health care providers (83%). Based on the results of the present study, context-specific house-to-house interventions will be designed and implemented.

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Assessment of drug utilization among geriatric patients based on defined daily dose concept in a rural tertiary care teaching hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20204092 ◽

2020 ◽

Vol 9 (10) ◽

pp. 1538

Author(s):

K. Padmavathi ◽

S. A. Arun Raaj ◽

S. Subash ◽

C. K. Dhanapal ◽

S. Periasamy

Keyword(s):

Drug Utilization ◽

Geriatric Patients ◽

Anatomical Therapeutic Chemical ◽

Tertiary Care ◽

Defined Daily Dose ◽

College Hospital ◽

Care Teaching ◽

Essential Drug List ◽

Daily Dose ◽

Collection Form

Background: The objectives of the study were to use the anatomical therapeutic chemical classification (ATC) /defined daily dose (DDD) concept to study the drug utilization pattern in geriatric patients in a rural tertiary care teaching hospital.Methods: An observational study was conducted at Rajah Muthiah Medical College Hospital (OPD and IPD) over a period of six months from November 2018 to April 2019. The data was collected from 204 patients using specially designed data collection form. The patients were selected based on inclusion and exclusion criteria. Results: A total of 204 patients were included in this study. The study population consisting of males 130 (63.7%) and females 74 (36.2%). Diseases related to the cardiovascular system 67 (32.84%) were the most common cause for the geriatric patients to attend the hospital, followed by surgical diseases 47 (23.03%), Oncological diseases 2 (0.98%) were the least frequency encountered. The average number of drugs prescribed per prescription was 8.79. Out of 1795 drugs prescribed, 60.86% of drugs were prescribed in generic form, and 39.14% were prescribed in brand name. The study analysed that 71.25% of drugs prescribed were from essential drug list (EDL) 2016-2018. Number of prescriptions with an injection was 74.04%. Paracetamol (N02B01) was the most frequently prescribed drug, followed by Amlodipine (C08CA01), Dexamethasone (H02AB02), Clopidogrel (B01AC04), Ferrous sulfate (B03AA07), Acetylsalicylic acid (B01AC06), Hydrocortisone (H02AB09), Tamsulosin (G04CA02), Atorvastatin (C10AA05), Furosemide (C03CA01).Conclusions: Drug utilization study can help in evaluating the quality of care given to the geriatric patients and promote rational use of medicines.

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