scholarly journals The Relevance of Defined Daily Dose concept in Drug Utilisation Research: A Review

2021 ◽  
Vol 11 (4-S) ◽  
pp. 162-165
Author(s):  
Agnus Baiju ◽  
Rosmin Jacob ◽  
K. Krishnakumar
Keyword(s):  
Drug Utilisation ◽  
Anatomical Therapeutic Chemical ◽  
Cost Effective ◽  
World Health Organisation ◽  
Economic Consequences ◽  
World Health ◽  
Special Focus ◽  
Defined Daily Dose ◽  
Rational Drug ◽  
Daily Dose

According to World Health Organisation (WHO), drug utilisation is defined as the marketing, distribution, prescription and the use of drugs in society with special focus on resulting medical, social and economic consequences and it has turned into a powerful scientific tool for ensuring the rational and cost-effective use of drugs. A standard method is required to identify and aggregate drug data. This manuscript provides an overview of the WHO Anatomical Therapeutic Chemical (ATC) classification and the associated measure, Defined Daily Dose (DDD), as a methodology for evaluating drug utilisation. Keywords: Drug utilisation research, Anatomical Therapeutic Chemical classification system, Defined Daily Dose, Rational drug use.

The Use of the World Health Organisation Anatomical Therapeutic Chemical/Defined Daily Dose Methodology in Canada

2004 ◽  
Vol 38 (1) ◽  
pp. 15-27 ◽  
Author(s):  
Ingrid S. Sketris ◽  
Colleen J. Metge ◽  
Jennifer L. Ross ◽  
Mary E. MacCara ◽  
Danna G. Comeau ◽  
...  
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
World Health Organisation ◽  
World Health ◽  
Defined Daily Dose ◽  
The World ◽  
Daily Dose

scholarly journals Analyzing Antidiabetes Drug Prescriptions With World Health Organization Anatomical Therapeutic Chemical/Defined Daily Dose Index to Assess Drug Utilization Pattern in Elderly Population of Rural Eastern India

2017 ◽  
Vol 8 ◽  
pp. 117739361770334 ◽  
Author(s):  
Sandeep Lahiry ◽  
Avijit Kundu ◽  
Ayan Mukherjee ◽  
Shouvik Choudhury ◽  
Rajasree Sinha
Keyword(s):  
World Health Organization ◽  
Drug Utilization ◽  
West Bengal ◽  
Anatomical Therapeutic Chemical ◽  
World Health ◽  
Defined Daily Dose ◽  
Prescription Data ◽  
Daily Dose ◽  
Health Organization

Objective: To analyze drug utilization (DU) pattern of antidiabetes drug (ADD) prescription in elderly type 2 diabetes mellitus (T2DM) in rural West Bengal based on 2016 World Health Organization (WHO) Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) Index. Methods: This was a prospective observational study. Prescription data of 600 elderly patients (age > 60 years) attending outpatient clinic were screened over 12 months (January 2015 to January 2016) from 5 different rural hospitals in West Bengal. Pooled data were sorted and classified in accordance with 2016 ATC/DDD WHO Index. Direct cost associated and consumption of ADD were measured as DDD/1000 patients/day. The adverse drug reactions (ADRs) related to antidiabetic medicines were monitored. Results: During the study period, mean age of patients recorded was 66.4 ± 5.0 years, with 66.6% (n = 396) having history of T2DM > 5 years. Follow-up encounters (n = 2328) revealed metformin (94.67%), sulfonylureas (SUs) (50.54%), pioglitazone (24.22%), voglibose (22.50%), insulin (9.75%), and acarbose (6.82%) to be more prevalent, constituting DU 90% (92.01%). Combination of metformin plus SU was recorded in most of the patients (56%). Insulin, however, was found to be an underutilized class ( P < .005). The DDD/1000 patients/day of metformin (2.918), glimepiride (1.577), and gliclazide (0.069) conformed to 2016 WHO ATC/DDD Index. The total ADD consumption during study period was 5.03 DDD/1000 patients/day. The average drug cost per encounter per day was Rs 11.24 ± 2.01. Nineteen ADRs were reported and their descriptions were found to be of hypoglycemia (n = 9), pedal edema (n = 2), and gastrointestinal upsets (n = 8). Target glycemic status was achieved in 40% monthly follow-up encounters. Low-store drug availability and poor compliance to treatment (>60%) were major determinants. Lack of regular aerobic exercises (>85%) and proper knowledge regarding medical nutrition therapy (MNT) (>80%) and low average consultation time (3.5 ± 0.6 minutes) were important contributing factors. Conclusions: The study exhibited increased utilization of 2 drug combinations of oral ADD and lower utilization of insulin during study period. Such inferences merit further exploration.

scholarly journals Gambaran Penggunaan Antibiotik di Bangsal Penyakit Dalam RSUD Bangil Kabupaten Pasuruan

2020 ◽  
Vol 5 (1) ◽  
pp. 12
Author(s):  
Sinta Rachmawati ◽  
Rizki Laili Fazeri ◽  
Ika Norcahyanti
Keyword(s):  
World Health Organization ◽  
Anatomical Therapeutic Chemical ◽  
World Health ◽  
Defined Daily Dose ◽  
Daily Dose ◽  
Health Organization

<p>Penggunaan antibiotik yang tidak tepat akan berdampak terhadap terjadinya resistansi. Oleh karena itu, studi penggunaan antibiotik perlu dilakukan di fasilitas pelayanan kesehatan, termasuk rumah sakit. Penelitian ini bertujuan untuk mengetahui gambaran penggunaan antibiotik di bangsal penyakit dalam Rumah Sakit Umum Daerah (RSUD) Bangil Kabupaten Pasuruan dengan menggunakan metode<em> Anatomical Therapeutic Chemical</em> (ATC)/<em>Defined Daily Dose</em> (DDD). ATC/DDD adalah metode perhitungan penggunaan antibiotik secara kuantitatif yang direkomendasikan oleh <em>World Health Organization</em> (WHO). Pengambilan data dilakukan secara retrospektif menggunakan sumber data excel berupa rekapitulasi rekam medik. Populasi pada penelitian ini adalah seluruh pasien rawat inap dewasa di bangsal penyakit dalam sepanjang tahun 2017. Sejumlah 973 data dari keseluruhan populasi memenuhi kriteria inklusi. Analisis data dilakukan berdasarkan pada karakteristik pasien, profil antibiotik dan perhitungan kuantitatif dengan metode ATC/DDD. Hasil penelitian menunjukkan bahwa golongan antibiotik yang paling banyak digunakan adalah golongan sefalosporin sebesar 51,41%, sedangkan jenis antibiotik yang paling banyak diresepkan yaitu ceftriaxone dengan jumlah sebesar 25,86%. DDD/100 <em>patient-days</em> tertingi adalah ceftriaxone dengan nilai 27,79 DDD/100 <em>patient-days</em>. Perlu dilakukan penelitian lanjutan dengan menggunakan metode Gyssens untuk mengetahui rasionalitas penggunaan antibiotik.</p>

scholarly journals Drug utilization pattern among geriatrics according to anatomical therapeutic chemical and defined daily dose classification in a tertiary care hospital

2019 ◽  
Vol 8 (9) ◽  
pp. 1989
Author(s):  
T. Muneswar Reddy ◽  
Thammi Setty Durga Prasad ◽  
Allikesam Hemalatha ◽  
Vanam Chanukya ◽  
Bandi Lakshmi Sirisha
Keyword(s):  
Drug Utilization ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Care ◽  
Essential Medicines ◽  
World Health ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Utilization Pattern ◽  
Geriatric Population ◽  
Daily Dose

Background: This study was conducted to determine the drug utilization pattern among geriatric inpatients in general medicine department of the hospital.Methods: An observational, prospective study was conducted for a period of six months (November 2016 to April 2017) among 200 geriatric patients; demographic details, education, occupation, diagnosis and drug details were recorded. The drugs were categorized by anatomical therapeutic classification (ATC) and defined daily dose (DDD) was calculated. The World Health Organization (WHO) prescribing indicators were assessed.Results: The majority of the patients (59%) were in age group of 60-69 years. Cardiovascular diseases were common among geriatrics. Most commonly prescribed drug was Pantoprazole (81.7%). Drugs were assigned with ATC/DDD codes according to the guidelines of WHO. Drugs prescribed by their generic names were 56.64% and 43% of drugs that were included in the National Essential Medicines List.Conclusions: Clinical pharmacist have to collaborate and work together with physicians in selecting and adjusting the dose among geriatric population in order to reduce development of potential adverse drug reactions, serious drug related complications and drug interaction.

scholarly journals Coding and classification in drug statistics – From national to global application

2009 ◽  
Vol 11 (1) ◽  
Author(s):  
Marit Rønning
Keyword(s):  
Drug Utilisation ◽  
Anatomical Therapeutic Chemical ◽  
Defined Daily Dose ◽  
Font Size ◽  
Annual Basis ◽  
Main Challenge ◽  
National Drug ◽  
Daily Dose ◽  
Drug Statistics ◽  
Important Basis

<strong><span style="font-family: TimesNewRomanPS-BoldMT;"><font face="TimesNewRomanPS-BoldMT"><p align="left"> </p></font></span><p align="left"><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;"><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;">SUMMARY</span></span></p><p align="left"><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;"></span></p></strong><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><span style="font-size: x-small; font-family: TimesNewRomanPSMT;">The Anatomical Therapeutic Chemical (ATC) classification system and the defined daily dose (DDD)<p align="left">was developed in Norway in the early seventies. The creation of the ATC/DDD methodology was an</p><p align="left">important basis for presenting drug utilisation statistics in a sensible way. Norway was in 1977 also the</p><p align="left">first country to publish national drug utilisation statistics from wholesalers on an annual basis. The</p><p align="left">combination of these activities in Norway in the seventies made us a pioneer country in the area of drug</p><p align="left">utilisation research. Over the years, the use of the ATC/DDD methodology has gradually increased in</p><p align="left">countries outside Norway. Since 1996, the methodology has been recommended by WHO for use in</p><p align="left">international drug utilisation studies. The WHO Collaborating Centre for Drug Statistics Methodology</p><p align="left">in Oslo handles the maintenance and development of the ATC/DDD system. The Centre is now responsible</p><p align="left">for the global co-ordination. After nearly 30 years of experience with ATC/DDD, the methodology</p><p align="left">has demonstrated its suitability in drug use research. The main challenge in the coming years is to</p><p>educate the users worldwide in how to use the methodology properly.</p></span></span>

scholarly journals EVALUATION OF ANTIBIOTIC USE IN 2018 AT THE KEBAYORAN BARU PRIMARY HEALTH CARE, INDONESIA, USING THE ANATOMICAL THERAPEUTIC CHEMICAL/DEFINED DAILY DOSE METHOD

2020 ◽  
pp. 78-82
Author(s):  
LARASATI ARRUM KUSUMAWARDANI ◽  
ATIKA WAHYU PUSPITASARI ◽  
VANNISA NABILLA WIDYANTARI
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Anatomical Therapeutic Chemical ◽  
Antibiotic Use ◽  
World Health ◽  
Defined Daily Dose ◽  
Oral Antibiotics ◽  
Design Data ◽  
Primary Health ◽  
Daily Dose

Objective: The abnormally high use of antibiotics can indicate irrational prescribing. One of the ways by which to support rationally prescribingantibiotics is by evaluating their frequency of use. This study aimed to evaluate the use of antibiotics in 2018 by outpatients at the Kebayoran BaruPrimary Health Care of Indonesia.Methods: The study was a cross-sectional and descriptive design. Data were collected retrospectively from sampling outpatient records. The data wereon oral antibiotics prescribed in 2018 at Kebayoran Baru Primary Health Care. There were 10,553 prescriptions for oral antibiotics used as the studysamples. Both quantitative and qualitative evaluations were conducted. The quantitative evaluations were conducted using the method recommendedby the World Health Organization, namely, the anatomical therapeutic chemical/defined daily dose (DDD), and the qualitative evaluations wereconducted using the 90% drug utilization (DU 90%) method and the suitability of antibiotic use with the list of drugs in the Indonesian nationalformulary for the first-level health facilities (FKTP).Results: Three of the antibiotics used most often were amoxicillin at 0.9358 DDD/1000 inhabitants/d, ciprofloxacin at 0.4940 DDD/1000inhabitants/d, and cefadroxil at 0.1983 DDD/1000 inhabitants/d. The drugs within the DU 90% segment were amoxicillin, ciprofloxacin, cefadroxil,and thiamphenicol. There was 70% compatibility of antibiotic use with Indonesian national formulary for the FKTP.Conclusion: We suggest that the use of antibiotics at Kebayoran Baru Primary Health Care tended to be on the high side and not in accordance withnational guidelines.

DRUG UTILIZATION EVALUATION AND COST ANALYSIS OF ANTIEMETIC DRUGS PRESCRIBED IN ONCOLOGY WARD IN A QUATERNARY CARE HOSPITAL

2016 ◽  
Vol 9 (5) ◽  
pp. 97
Author(s):  
Ardeshna A Nishita ◽  
Darabadi Rispa ◽  
Reddy Harshini Y ◽  
Srinivasan R
Keyword(s):  
Drug Use ◽  
Drug Utilization ◽  
Cost Effective ◽  
Economic Consequences ◽  
World Health ◽  
Care Hospital ◽  
Standard Protocol ◽  
Rational Drug ◽  
Patient Profiles ◽  
Health Organization

ABSTRACTObjective: Drug utilization is defined by the World Health Organization as the marketing, distribution, prescription, and use of drugs in society, withspecial emphasis on the resulting medical, social, and economic consequences. Our study is done to obtain the variation of drug use and costs ofdrug therapy, from which medical and social qualitative consequences can be found. Our study emphasizes on knowing the drug utilization and costincluded for antiemetics in patients undergoing chemotherapy in oncology ward.Methods: It was observational, prospective and non-interventional study.Results: Total of 141 patients were studied, out of which 77 (54.6%) patients were female and 64 (45.4%) patients were males. The majority of thepatients in this study belong to the age group of 40-49 (29%) and 60-69 (20%) years. The comparison with the standard protocol was made accordingto the use of antiemetics in the patients. Out of which, 137 (97%) patient profiles were found to be deviating from standard protocol, and 4 (3%)patient profiles were found following the standard protocol because of including prochlorperazine which is not mentioned in the standard protocol.Conclusion: As of future approach, education to physician for rational drug use and review of medication chart with patient consideration can givebetter health care and also cost effective treatment.Keywords: Drug use evaluation, Antiemetics, Chemotherapy.

scholarly journals Drug utilisation trends in a physical rehabilitation hospital

2019 ◽  
Vol 76 (12) ◽  
pp. 1261-1267
Author(s):  
Gordana Ljubojevic ◽  
Milan Mastikosa ◽  
Tanja Dostanic-Dosenovic ◽  
Snjezana Novakovic-Bursac ◽  
Natasa Tomic ◽  
...  
Keyword(s):  
Drug Utilisation ◽  
World Health Organisation ◽  
Prescribing Patterns ◽  
World Health ◽  
Defined Daily Dose ◽  
Thioctic Acid ◽  
Anatomic Therapeutic Chemical ◽  
Rehabilitation Hospital ◽  
Annual Change Rate ◽  
Prescribing Practice

Background/Aim. Drug utilisation monitoring could identify drug-related problems and hence improve the awareness of irrational drug use. The objective of this study was to analyse the drug utilisation patterns in a rehabilitation hospital over the period 2011?2016. Methods. The Anatomic Therapeutic Chemical classification/Defined Daily Dose (ATC/DDD) methodology was used to monitor the drug utilisation expressed as a number of DDD per 100 patient-days (HPD). The values of DDDs were obtained from the World Health Organisation (WHO) Collaborating Centre for Drug Statistics Methodology. Utilisation trends were analysed by means of the Compound Aggregate Growth Rate (CAGR), which is defined as an average annual change rate of some value during the period of interest. Results. The number of patient-days increased during the six years period; the CAGR being1.8% annually. At the same time, the total number of dispensed DDDs as well as the number of DDD/HPD decreased with the CAGR of -2.0% and -3.7% respectively. The average drug cost per patient-day varied from BAM 1.38 in 2013 to 0.95 in 2016; the CAGR being -1.8%. The most utilised drugs belonged to the ATC groups C, A, B, M and N and they contributed to an average of 77% of all drugs used each year. On the top of the list of most utilised drugs were: hydroxocobalamin, thioctic acid, enalapril, diclofenac, amlodipine, acetylsalicylic acid, pantoprazole, paracetamol and bromazepam. Conclusions. The overall drug utilisation in the hospital was modest and almost equal in 2016 compared to 2011. Besides the leading consumption of vitamin B12 and thioctic acid, this study points out some interesting prescribing patterns, such as predominant use of diclofenac over ibuprofen, and overuse of proton pump inhibitors. There is a need for educative interventions among physicians in order to improve their prescribing practice.

scholarly journals Radical cystectomy: Analysis of postoperative course

2010 ◽  
Vol 67 (8) ◽  
pp. 649-652
Author(s):  
Dimitrije Jeremic ◽  
Sasa Vojinov ◽  
Goran Marusic ◽  
Ivan Levakov ◽  
Srdjan Zivojinov
Keyword(s):  
Postoperative Complications ◽  
Radical Cystectomy ◽  
Anatomical Therapeutic Chemical ◽  
World Health ◽  
Defined Daily Dose ◽  
Postoperative Course ◽  
Clinical Center ◽  
Daily Dose ◽  
Blood Utilization ◽  
Health Organization

Background/Aim. Radical cystectomy is a method of choice in the therapy of infiltrative bladder cancer. The aim of this research was to analyze postoperative course after radical cystectomy (length of hospitalization, most frequent complications and utilization of antibiotics and transfusions). Methods. We analyzed the records of 82 patients operated on in the Department of Urology, Clinical Center of Vojvodina, in a three-year period. In order to aquire data World Health Organization (WHO) has developed Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology. Defined daily dose (DDD) is the assumed average maintenance dose per day for a drug use for its main indication. Results. Continent urinary derivation was preformed in 23.15% cases. Postoperative complications occurred in 18.29% of patients. Average blood utilization was 2.19 units. Blood utilization for continent derivations (n = 48) was 4.6 units, and incontinent ones 3.36 units. Totally 159.33 DDD/100 bed days were used. Conclusion. When preforming continent derivation there is a significant increase in blood utilization. Frequency of postoperative complications correlates to those reported in the literature.

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