CONSUMPTION TREND OF OPIOIDS IN AMBULATORY PATIENTS IN ALBANIA 2014-2019

Aim: To evaluate the patterns of use of the out-of-hospital Anti-Asthmatic drugs in Albania during the period 2004-2014. Methods: The study was retrospective and we analyzed the prescription and consumption of these drug classes in the primary health care in Albania during 2004-2014. All data were collected from Health Insurance Institute (HII)[1] and analysed reflecting the ambulatory and outpatient use for the period 2004-2014. The data about the consumption of drugs were expressed as a number of Defined Daily Dose (DDDs) /1000 inhabitants/day. Utilization was measured in DDD/1000 inhabitants/day and was also compared with Bronchial Asthma morbidity/1000 inhabitants, to understand the covering of the population from the reimbursement scheme. For all the period under study 2004-2014, there were collected and analysed the data of import and domestic production of drugs, which altogether represent the real consumption of drugs in the country. These data were subsequently included in a comparative analysis with the utilization data according to the HII. Results: The values of consumption of Anti-Asthmatic drugs were 6.62-8.48 DDD/1000 inhabitants/day respectively in 2004-2014. 2.14-3.76 DDD/1000 inhabitants/day constitute the consumption of beta2 agonists and 2.66-3.69 DDD/1000 inhabitants/day is the consumption of corticosteroids. In addition, it turns out that the consumption of beclometasone and the association Beta-2-mimetic-corticosteroids (salmeterol+fluticasone) based on HII data is superior to the consumption of this forms based on Import data, which cannot be true. This finding probably reflects fictive prescriptions and the entry of drugs by contraband. During some years of our study we notice that the consumption of Antiasthmatic drugs is higher than the morbidity level (cases/1000 inhabitants). Conclusions There is only a small increase in the national consumption of Anti-Asthmatic drugs during these years, but the values still remain very low in comparison with other countries. Less than 40% of the consumption of beta2 agonists is covered from the reimbursement scheme. In addition, it results that the scheme covers about 50% of antiasthmatic drugs consumption.

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Utilization Patterns of Anti-Asthmatic Drugs Use in Albania During 2004-2014

European Journal of Interdisciplinary Studies ◽

10.26417/ejis.v3i2.p76-84 ◽

2017 ◽

Vol 3 (2) ◽

pp. 76

Author(s):

Laerta Kakariqi

Keyword(s):

Defined Daily Dose ◽

Asthma Morbidity ◽

Primary Health ◽

Patterns Of Use ◽

Drug Classes ◽

Daily Dose ◽

Utilization Data ◽

Reimbursement Scheme ◽

Utilization Patterns ◽

Beta 2

Aim: To evaluate the patterns of use of the out-of-hospital Anti-Asthmatic drugs in Albania during the period 2004-2014. Methods: The study was retrospective and we analyzed the prescription and consumption of these drug classes in the primary health care in Albania during 2004-2014. All data were collected from Health Insurance Institute (HII)[1] and analysed reflecting the ambulatory and outpatient use for the period 2004-2014. The data about the consumption of drugs were expressed as a number of Defined Daily Dose (DDDs) /1000 inhabitants/day. Utilization was measured in DDD/1000 inhabitants/day and was also compared with Bronchial Asthma morbidity/1000 inhabitants, to understand the covering of the population from the reimbursement scheme. For all the period under study 2004-2014, there were collected and analysed the data of import and domestic production of drugs, which altogether represent the real consumption of drugs in the country. These data were subsequently included in a comparative analysis with the utilization data according to the HII. Results: The values of consumption of Anti-Asthmatic drugs were 6.62-8.48 DDD/1000 inhabitants/day respectively in 2004-2014. 2.14-3.76 DDD/1000 inhabitants/day constitute the consumption of beta2 agonists and 2.66-3.69 DDD/1000 inhabitants/day is the consumption of corticosteroids. In addition, it turns out that the consumption of beclometasone and the association Beta-2-mimetic-corticosteroids (salmeterol+fluticasone) based on HII data is superior to the consumption of this forms based on Import data, which cannot be true. This finding probably reflects fictive prescriptions and the entry of drugs by contraband. During some years of our study we notice that the consumption of Antiasthmatic drugs is higher than the morbidity level (cases/1000 inhabitants). Conclusions There is only a small increase in the national consumption of Anti-Asthmatic drugs during these years, but the values still remain very low in comparison with other countries. Less than 40% of the consumption of beta2 agonists is covered from the reimbursement scheme. In addition, it results that the scheme covers about 50% of antiasthmatic drugs consumption.

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The use of anti-hyperlipidemia in a private hospital in Yogyakarta during 2013-2019

Jurnal Ilmiah Farmasi ◽

10.20885/jif.vol17.iss2.art7 ◽

2021 ◽

Vol 17 (2) ◽

pp. 173-181

Author(s):

Yosi Febrianti ◽

Saepudin Saepudin ◽

Dian Medisa ◽

Haryo Tetuko ◽

Nurul Fadhillah Hasanah

Keyword(s):

Hospital Pharmacy ◽

Private Hospital ◽

Fold Increase ◽

Hospitalized Patients ◽

Defined Daily Dose ◽

Primary And Secondary Prevention ◽

Pharmacy Department ◽

Daily Dose ◽

Bed Days ◽

Lipid Modifying Agents

Background: Lipid modifying agents have an important role in the primary and secondary prevention of cardiovascular diseases such as coronary heart disease and stroke. The use of lipid-modifying agents tends to increase along with the increasing prevalence of these diseases. Objectives: To determine the utilization of lipid modifying agents for hospitalized patients in a private hospital in Yogyakarta during the period of 2013 - 2019 in regard to the agents used and their quantity. Methods: The main data for this study were aggregate data on the use of lipid modifying agents for hospitalized patients during 2013-2019 obtained from the hospital pharmacy department. After identification of the names of lipid modifying agents, the quantities of these drugs were then calculated in units of defined daily dose (DDD) and the final quantity was expressed in DDD/100 bed days (BD). The R2 value from linear regression was used to determine the trend of use of individual agents over the period. Results: There were two pharmacological subgroups of lipid modifying agents used during the period of 2013 – 2019 with an average of total quantity of 14.81 DDD/100 BD. Utilization of statins was approximately 90% of the total use, and utilization of fibrates tended to decrease over the period. Individually, simvastatin use decreased significantly over the period (R2 = 0.885), but atorvastatin use continued to increase (R2 = 0.908) with 10-fold increase from 2013 to 2019. Conclusion: The lipid modifying agents used during the period 2013 - 2019 were predominantly statins, and the utilization of atorvastatin increased significantly during this period. Keywords: lipid modifying agents, ATC/DDD, fibrates, statins

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Antibiotic use in Albania between 2011 and 2012

The Journal of Infection in Developing Countries ◽

10.3855/jidc.5375 ◽

2015 ◽

Vol 9 (01) ◽

pp. 094-098 ◽

Cited By ~ 4

Author(s):

Iris Hoxha ◽

Admir Malaj ◽

Ledjan Malaj

Keyword(s):

Antibiotic Use ◽

World Health ◽

Measurement Unit ◽

Defined Daily Dose ◽

Anatomic Therapeutic Chemical ◽

Daily Dose ◽

Health Institutions ◽

Health Organization ◽

Official Data

Introduction: Health institutions in Albania have recently reported an increase in antibiotic misuse and microbial resistance. Until now, there have been no comprehensive studies that analyzed the overall use of antibiotics in Albania. The aim of this study was to analyze the overall antibiotic use in Albania between 2011 and 2012, using standardized methodology of measurement, based on World Health Organization guidelines. Methodology: Data from 2011 and 2012 on antibiotic use from ambulatory and hospital sector were examined. Antibiotics were divided based on anatomic therapeutic chemical classification. Defined daily dose (DDD) for each drug was assigned, and DDD per 1,000 inhabitants per day (DID) was used as a measurement unit. In cases of antibiotic combinations for which DDD were not available, unit doses were assigned. Results: In 2011–2012, total antibiotic use decreased from 24.25 to 20.66 DID. Penicillin’s were the most used antibiotic class, with 10.62 DID (2011) and 10.51 DID (2012). Tetracycline use decreased from 5.45 DID (2011) to 0.98 DID (2012). Macrolides increased from 1.36 to 1.88 DID, quinolones from 1.72 to 2.51 DID. The overall antibiotic use was significantly higher than the reimbursed antibiotic use – 3.17 DID (2011) and 2.79 DID (2012) – based on the official data for the same period. Conclusions: This study enables policymakers to further analyze the quality of antibiotic prescriptions and draw comparisons to other countries. The analyzed data suggest there are different factors influencing out-of-pocket use of antibiotics and wrongly prescribed antibiotics. Further studies are necessary to evaluate these factors.

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Comparison of the defined daily dose and days of treatment methods for evaluating the consumption of antibiotics and antifungals in the intensive care unit

Medicina Intensiva ◽

10.1016/j.medin.2019.06.008 ◽

2020 ◽

Vol 44 (5) ◽

pp. 294-300 ◽

Cited By ~ 1

Author(s):

J. Vallès ◽

S. Fernández ◽

E. Cortés ◽

A. Morón ◽

E. Fondevilla ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Defined Daily Dose ◽

Treatment Methods ◽

Daily Dose

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Broad-Spectrum Antibiotic Regimen Affects Survival in Patients Receiving Nivolumab for Non-Small Cell Lung Cancer

Pharmaceuticals ◽

10.3390/ph14050445 ◽

2021 ◽

Vol 14 (5) ◽

pp. 445

Author(s):

Min Jung Geum ◽

Chungsoo Kim ◽

Ji Eun Kang ◽

Jae Hee Choi ◽

Jae Song Kim ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Broad Spectrum ◽

Small Cell ◽

Defined Daily Dose ◽

Small Cell Lung ◽

Broad Spectrum Antibiotic ◽

Negatively Associated ◽

Daily Dose

Antibiotic-induced dysbiosis may affect the efficacy of immune checkpoint inhibitors. We investigated the impact of antibiotics on the clinical outcomes of nivolumab in patients with non-small cell lung cancer (NSCLC). Patients who received nivolumab for NSCLC between July 2015 and June 2018 and who were followed up until June 2020 were included in a retrospective cohort analysis. Of 140 eligible patients, 70 were on antibiotics. Overall survival (OS) was shorter in patients on antibiotics (ABX) compared to those not on antibiotics (NoABX) (p = 0.014). OS was negatively associated with piperacillin/tazobactam (PTZ) (HR = 3.31, 95% CI: 1.77–6.18), days of therapy (DOT) ≥ 2 weeks (HR = 2.56, 95% CI: 1.30–5.22) and DOT of PTZ. The defined daily dose (DDD) in PTZ (r = 0.27) and glycopeptides (r = 0.21) showed weak correlations with mortality. There was no difference in progression-free survival (PFS) between ABX and NoABX; however, PFS was negatively associated with the antibiotic class PTZ and DOT of PTZ. Therefore, the use of a broad-spectrum antibiotic, such as PTZ, the long-term use of antibiotics more than 2 weeks in total and the large amount of defined daily dose of specific antibiotics were associated with decreased survival in patients receiving nivolumab for NSCLC.

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

British Journal of Clinical Pharmacology ◽

10.1111/bcp.14770 ◽

2021 ◽

Author(s):

Catarina Abrantes ◽

Fernanda S. Tonin ◽

Joana Reis‐Pardal ◽

Margarida Castel‐Branco ◽

Claudia Furtado ◽

...

Keyword(s):

Drug Utilization ◽

Defined Daily Dose ◽

Utilization Research ◽

Daily Dose ◽

Drug Utilization Research ◽

Research Studies

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National Antimicrobial Consumption: Analysis of Central Warehouses Supplies to In-Patient Care Health Facilities from 2017 to 2019 in Uganda

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed6020083 ◽

2021 ◽

Vol 6 (2) ◽

pp. 83

Author(s):

Juliet Sanyu Namugambe ◽

Alexandre Delamou ◽

Francis Moses ◽

Engy Ali ◽

Veerle Hermans ◽

...

Keyword(s):

Inpatient Care ◽

Health Facilities ◽

World Health ◽

Defined Daily Dose ◽

Antimicrobial Consumption ◽

National Medical ◽

The World ◽

Daily Dose ◽

Care Health ◽

Health Organization

Antimicrobial consumption (AMC) surveillance at global and national levels is necessary to inform relevant interventions and policies. This study analyzed central warehouse antimicrobial supplies to health facilities providing inpatient care in Uganda. We collected data on antimicrobials supplied by National Medical Stores (NMS) and Joint Medical Stores (JMS) to 442 health facilities from 2017 to 2019. Data were analyzed using the World Health Organization methodology for AMC surveillance. Total quantity of antimicrobials in defined daily dose (DDD) were determined, classified into Access, Watch, Reserve (AWaRe) and AMC density was calculated. There was an increase in total DDDs distributed by NMS in 2019 by 4,166,572 DDD. In 2019, Amoxicillin (27%), Cotrimoxazole (20%), and Metronidazole (12%) were the most supplied antimicrobials by NMS while Doxycycline (10%), Amoxicillin (19%), and Metronidazole (10%) were the most supplied by JMS. The majority of antimicrobials supplied by NMS (81%) and JMS (66%) were from the Access category. Increasing antimicrobial consumption density (DDD per 100 patient days) was observed from national referral to lower-level health facilities. Except for NMS in 2019, total antimicrobials supplied by NMS and JMS remained the same from 2017 to 2019. This serves as a baseline for future assessments and monitoring of stewardship interventions.

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