scholarly journals Spirometry monitoring in asthmatic children in Lombardy Region, Italy

2018 ◽  
Vol 2 (1) ◽  
pp. e000334
Author(s):  
Pietro Casartelli ◽  
Antonio Clavenna ◽  
Massimo Cartabia ◽  
Angela Bortolotti ◽  
Ida Fortino ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Inhaled Corticosteroids ◽  
Drug Prescription ◽  
Administrative Databases ◽  
Function Evaluation ◽  
Local Health ◽  
Local Health Unit ◽  
Lombardy Region ◽  
Asthmatic Children ◽  
Antiasthmatic Drug

ObjectivesTo evaluate the diagnostic and therapeutic approaches in a cohort of asthmatic children before and after starting drug therapy.MethodsData were retrieved from administrative databases of the Lombardy Region. The study population was composed of 78 184 children born in the Lombardy Region in 2002 and followed until their 10th birthday.Children with at least one antiasthmatic drug prescription per year (with the exclusion of nebulised suspension/solution formulations) in 2 consecutive years and at least one antiasthmatic drug prescription after the fifth birthday were identified as potential asthmatics (PA).Each PA was monitored for a period starting from 12 months before and ending 24 months after the first prescription (index prescription, IP). During the monitoring period antiasthmatic drug prescriptions were analysed, as well as spirometry and/or specialist visits.ResultsA total of 59 975 children (76.7%) received ≥1 prescription of antiasthmatic drugs in their first 10 years of life, and 4475 (5.7%) were identified as PAs. In all, 24% of PAs started with short-acting β2-agonists (SABA), 23% with inhaled corticosteroids (ICS) and 20% with SABA+ICS.A total of 33% of PAs had at least one prescription for specialist visit/spirometry: 11% before and 28% after the IP. The factors associated with a greater likelihood of receiving visit/spirometry prescriptions were local health unit of residence, age and high use of asthma drugs.ConclusionsDespite international guideline recommendations, spirometry monitoring is still underused in asthmatic children, even in subjects who initiated pharmacological treatment and therefore need an airway function evaluation. Moreover, the choice of drug therapy appears not always rational, since one out of four children were commenced on ICS as monotherapy.

scholarly journals A Network Approach for the Study of Drug Prescriptions: Analysis of Administrative Records from a Local Health Unit (ASL TO4, Regione Piemonte, Italy)

2021 ◽  
Vol 18 (9) ◽  
pp. 4859
Author(s):  
Gianluca Miglio ◽  
Lara Basso ◽  
Lucrezia G. Armando ◽  
Sara Traina ◽  
Elisa Benetti ◽  
...  
Keyword(s):  
Administrative Data ◽  
Anatomical Therapeutic Chemical ◽  
Drug Prescription ◽  
Local Health ◽  
Prescription Data ◽  
Health Unit ◽  
Local Health Unit ◽  
Administrative Records ◽  
Edge Linking ◽  
Novel Approach

In a Drug Prescription Network (DPN), each drug is represented as a node and two drugs co-prescribed to the same patient are represented as an edge linking the nodes. The use of DPNs is a novel approach that has been proposed as a means to study the complexity of drug prescription. The aim of this study is to demonstrate the analytical power of the DPN-based approach when it is applied to the analysis of administrative data. Drug prescription data that were collected at a local health unit (ASL TO4, Regione Piemonte, Italy), over a 12-month period (July 2018–June 2019), were used to create several DPNs that correspond to the five levels of the Anatomical Therapeutic Chemical classification system. A total of 5,431,335 drugs prescribed to 361,574 patients (age 0–100 years; 54.7% females) were analysed. As indicated by our results, the DPNs were dense networks, with giant components that contain all nodes. The disassortative mixing of node degrees was observed, which implies that non-random connectivity exists in the networks. Network-based methods have proven to be a flexible and efficient approach to the analysis of administrative data on drug prescription.

Triptan use in Italy: Insights from administrative databases

Cephalalgia ◽  
2014 ◽  
Vol 35 (7) ◽  
pp. 619-626 ◽  
Author(s):  
Roberto Da Cas ◽  
Anna Nigro ◽  
Salvatore Terrazzino ◽  
Grazia Sances ◽  
Michele Viana ◽  
...  
Keyword(s):  
At Risk ◽  
Drug Prescription ◽  
Medication Overuse Headache ◽  
Administrative Databases ◽  
Local Health ◽  
Italian Population ◽  
Frequent Users ◽  
Defined Daily Doses ◽  
Umbria Region ◽  
Prescription Databases

Introduction In this drug utilization study, we aimed at assessing the pattern of triptan use in Italy by means of the drug prescription databases of two local health authorities, accounting for approximately 1 million citizens. Methods The study population included all residents aged 18 to 84 years in the Vercelli province (about 175,000 inhabitants) and in the Umbria region (about 885,000 inhabitants), who had at least one dispensation for triptans in 2012. A frequent user, who might be at risk of medication-overuse headache (MOH), was defined as a patient being dispensed at least 10 defined daily doses (DDD) of triptans every month for at least three consecutive months. Results Triptans were used by 0.7%–1% of the population. While most patients were dispensed fewer than 60 DDDs per year, about 10% of all triptan users were classified as frequent users. In both areas, patients below the age of 29 were less likely to be frequent users while the 40- to 49-year-old population was the most affected, with no sex difference. About two-thirds of frequent users persisted in this behavior for an additional three-month period in the following six months. Conclusions Our data indicate that approximately 10% of all triptan users in the Italian population are potentially at risk for MOH. An approach based on drug prescription databases could be useful to identify patients at risk for MOH.

scholarly journals Clinical and treatment profiles of patients affected by acute coronary syndromes derived from administrative databases in the ASSL 10 Veneto orientale

2015 ◽  
Vol 76 (1) ◽  
Author(s):  
Paolo Piergentili ◽  
Roberto Valle ◽  
Loredano Milani
Keyword(s):  
Myocardial Infarction ◽  
Sharp Decrease ◽  
Administrative Databases ◽  
First Year ◽  
Sample Population ◽  
Local Health ◽  
Local Health Unit ◽  
Number Of Patients ◽  
Second Year

Background. This paper presents a revision of services provided to patient over two years following a myocardial infarction (MI) based on data derived from administrative databases. The study aims to evaluate the burden and the resources consumed by these patients, as well as the adherence to clinical guidelines. Methods. All patient hospitalised for myocardial infarction in the cardiology unit of the hospital of San Donà di Piave (Venice, Italy) were identified. The clinical record was reviewed to reconstruct clinical history. Then from the Local Health Unit n. 10 all information regarding these patient were collected and analysed after record linkage. Results. The patients with MI were 236. Of these, 20 died during the first hospitalization, 2 were lost to the follow up and 40 died within the two years period. The 214 patients who were alive after the first hospitalization produced 447 ordinary and 57 day hospital hospitalization. Specialist services were 23.250, and of these 17.583 were evaluated as being related to the cardiac disease. The value of drug prescribed over the two year period was € 553.108. The number of prescriptions belonging to the anatomic ATC class C were 29.076, received by 210 people. The mean pro capita estimated cost was € 22.058 in the first year, and € 6.226 in the second year. Conclusions. The characteristics of the sample population of our patients with MI were similar to those described in the literature. Follow up showed a sharp decrease of care and services received by patients during the second year after the acute event. In addition, a large part of services was not related to the cardiac diseases. Only a limited number of patients followed a rehabilitation programme. The estimated pro capita overall cost was very relevant in the first year, and the difference with the cost of the second year suggests a fall over time of the relevance attributed by the patients to the cardiac problems.

scholarly journals Analisi della persistenza e delle risorse allocate nel trattamento farmacologico dell’ipertensione arteriosa

2002 ◽  
Vol 3 (3) ◽  
pp. 161-170
Author(s):  
Luca Degli Esposti ◽  
Alessandro Capone ◽  
Ezio Degli Esposti ◽  
Giorgio Valpiani ◽  
Mirko Di Martino ◽  
...  
Keyword(s):  
Antihypertensive Treatment ◽  
Hospital Admissions ◽  
Beta Blockers ◽  
Population Based ◽  
Administrative Databases ◽  
Local Health ◽  
Channel Blockers ◽  
Related Factors ◽  
Local Health Unit ◽  
Hypertensive Drug

In this study, the persistence with treatment and resources allocated in antihypertensive pharmacotherapy has been evaluated. Administrative databases of the Local Health Unit of Ravenna listing patients baseline characteristics, drug prescriptions and hospital admissions were used to perform a population-based retrospective study. All new users 20 years old or over receiving a first prescription for diuretics, beta-blockers, calcium channel-blockers, ACE inhibitors or AII-Antagonists between January 1st, 1997 and December 31st, 1997 were included. A one-year follow-up for prescriptions of anti-hypertensive drugs were considered. According to duration of therapy, treated population was divided in persistent patients (continuers and switchers) and non-persistent patients. A total of 16,783 patients was included in the study of whom 64.9% were non-persistents. Persistence with treatment seems to be associated with the class of anti-hypertensive drug initially prescribed, and with patient-related factors. Patients initially prescribed for AII-Antagonists were more likely to persist than those starting on the other antihypertensive classes. Annual antihypertensive treatment cost accounted for • 1,076,053.55 of which 25.4% for non-persistent patients. An appropriate use of claims data may be considered as a powerful tool, providing detailed epidemiological and economic information concerning the antihypertensive treatment.

POLYPHARMACY IN ELDERLY OUT PATIENTS

2019 ◽  
pp. 16-22
Author(s):  
E.A. Panova ◽  
V.A. Serov ◽  
A.M. Shutov ◽  
N.N. Bakumtseva ◽  
M.Yu. Kuzovenkova
Keyword(s):  
Drug Therapy ◽  
Elderly Patients ◽  
Drug Prescription ◽  
Daily Practice ◽  
Drug Prescriptions ◽  
Ulcer Disease ◽  
Start Criteria ◽  
Therapeutic Value ◽  
Elderly Outpatients ◽  
Oncological Diseases

The aim of the work is to study the daily practice of prescribing drugs at the outpatient stage of medical care and to analyze the data obtained based Beers 2012 criteria and STOPP / START version 1. Materials and Methods. The authors analyzed drug prescriptions for 150 outpatients, who were over 65 years old. Results. Cardiovascular diseases, diseases of the osteo-articular system and type 2 diabetes mellitus prevailed in the morbidity structure of patients. Oncological diseases, thyroid diseases, bronchial asthma, cataracts, pancreatitis, anemia, peptic ulcer disease were diagnosed in some patients. All drug prescriptions during the year were taken into account. Simultaneous prescription of more than 4 drugs was considered polypharmacy. All the patients were monitored for a year since drug prescriptions had been made. Death was taken as the end point. The authors considered drug therapy to be irrational according to Beers and STOPP / START criteria. The therapeutic value of drug prescription audit based on restrictive lists was evaluated. Conclusions. Polypharmacy is observed in more than half of elderly outpatients. According to Beers 2012 criteria, irrational drug therapy was detected in 20 % of elderly patients, according to STOPP and START lists – in 43.3 % and 66.6 %, respectively. The lack of drug prescriptions in accordance with START criteria is associated with increased mortality of elderly patients. Keywords: polypharmacy, pharmacotherapy, drug therapy, geriatrics, restrictive lists, Beers criteria, STOPP / START criteria. Цель работы – изучение ежедневной практики назначения лекарственных препаратов на амбулаторном этапе медицинской помощи и анализ полученных данных на основе критериев ограничительных перечней Бирса 2012 г. и STOPP/START версии 1. Материалы и методы. Проанализированы лекарственные назначения 150 пациентам старше 65 лет, находившимся на амбулаторном лечении. Результаты. В структуре заболеваемости пациентов преобладали сердечно-сосудистые заболевания, а также болезни костно-суставной системы и сахарный диабет 2-го типа. Онкологические заболевания, заболевания щитовидной железы, бронхиальная астма, катаракта, панкреатит, анемия, язвенная болезнь диагностированы у единичных больных. Учитывались все лекарственные назначения в течение года. За полипрагмазию принималось одновременное назначение более 4 препаратов. В течение последующего года отслеживалось состояние пациентов, за конечную точку принята смерть. Выявлена нерациональная лекарственная терапия на основе критериев Бирса и STOPP/START. Оценена терапевтическая значимость аудита лекарственных назначений по ограничительным перечням. Выводы. Полипрагмазия наблюдается более чем у половины амбулаторных пациентов пожилого возраста. На основе критериев ограничительных перечней Бирса 2012 г. нерациональная лекарственная терапия выявлена у 20 % пациентов пожилого возраста, на основе критериев STOPP и START – у 43,3 и 66,6 % соответственно. Отсутствие назначений лекарств в соответствии с критериями START ассоциировано с увеличением смертности пациентов пожилого возраста. Ключевые слова: полипрагмазия, фармакотерапия, лекарственная терапия, гериатрия, ограничительные перечни, критерии Бирса, критерии STOPP/START.

scholarly journals Adrenal Function and Linear Growth in Asthmatic Children Treated with High Dose Inhaled Corticosteroids (ICS)

1998 ◽  
Vol 44 (3) ◽  
pp. 455-455
Author(s):  
C Dunlop ◽  
J McNaboe ◽  
H J Steen ◽  
D Carson ◽  
B Sheridan ◽  
...  
Keyword(s):  
Linear Growth ◽  
Inhaled Corticosteroids ◽  
Adrenal Function ◽  
High Dose ◽  
Asthmatic Children

Evaluation of the prescription and utilization patterns of statins in an Italian local health unit during the period 1994–2003

2007 ◽  
Vol 63 (2) ◽  
pp. 197-203 ◽  
Author(s):  
Paola Deambrosis ◽  
Cristina Saramin ◽  
Gianni Terrazzani ◽  
Luca Scaldaferri ◽  
Patrizia Debetto ◽  
...  
Keyword(s):  
Local Health ◽  
Health Unit ◽  
Local Health Unit ◽  
Utilization Patterns

scholarly journals Asthmatic children that are uncontrolled despite inhaled corticosteroids have a distinct breathprint (the pacman2 study)

2015 ◽  
Vol 5 (S2) ◽  
Author(s):  
Susanne Vijverberg ◽  
Paul Brinkman ◽  
Jan Raaijmakers ◽  
Kors van der Ent ◽  
Peter Sterk ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Asthmatic Children

scholarly journals Subclinical hypothyroidism in paediatric population treated with levothyroxine: a real-world study on 2001–2014 Italian administrative data

2017 ◽  
Vol 6 (6) ◽  
pp. 367-374 ◽  
Author(s):  
Nella Augusta Greggio ◽  
Elisa Rossi ◽  
Silvia Calabria ◽  
Alice Meneghin ◽  
Joaquin Gutierrez de Rubalcava ◽  
...  
Keyword(s):  
Real World ◽  
Subclinical Hypothyroidism ◽  
Paediatric Population ◽  
Mean Value ◽  
Administrative Databases ◽  
Slight Reduction ◽  
Local Health ◽  
Annual Dose ◽  
Historical Cohort ◽  
Low Dosage

Objective To estimate the prevalence of subclinical hypothyroidism (SH) among children, by using levothyroxine low dosage as disease proxy, and to describe prescription pattern. Design An historical cohort study was performed through administrative databases of 12 Italian Local Health Units covering 3,079,141 inhabitants. A cohort of children (aged 0–13 years) was selected in the period 2001–2014. A subgroup of new users (aged 0–9 years) was identified and followed up for 5 years. Methods The prevalence was provided as mean value of the whole period, as annual trend, by patient gender and age. Demographic details, information on levothyroxine dosage, comorbidities and co-medications were provided. Therapy duration and medication persistence were evaluated among new users. Results 644 children treated with levothyroxine low dosage was selected, with a mean annual prevalence of 0.20 per 1000 children. The temporal trend of prevalence was stable, with a slight reduction in the 2005–2008. Prevalence by age showed an increase after 10 years. Patients were treated with an average annual dose of 4290 µg/year and 66.9% of children were affected by comorbidities. Among 197 new users, 62.9% received therapy only for one year, whereas out of those treated two or more years, 89.0% resulted persistent to the therapy. Conclusions This study provides real-world epidemiology of SH among children, and it depicts the clinical and therapeutic characteristics of these subjects. Its findings showed that the SH treatment of this disorder was widely variable, also due to lack of evidence concerning paediatric population.

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