Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    ISSN: 1432-1041
    Keywords: Digoxin ; diuretics ; drug compliance ; drug utilization ; intoxication ; plasma levels
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Plasma digoxin was measured in all patients receiving digoxin (Lanacrist, Draco) in a well-defined low density population area in Sweden. The number of treated patients (n=75) corresponded to 3 % of the population. The average prescribed daily dose of digoxin was 0.25 mg, and the mean plasma concentration (n=74) was 0.85 (S.D. 0.52) ng/ml. Of the concentrations found 3 % were above and 62 % were below the apparent therapeutic range, 1 – 2 ng/ml. The findings were compared with analyses performed in a hospital laboratory (n=300), the majority being inpatients receiving a similar daily dose. In the latter, 22 % had a plasma level above and about 33 % below the apparent therapeutic range. In the former group no difference in plasma digoxin concentration could be demonstrated between patients treated with digoxin (n=34) and those treated with both digoxin and diuretics (n=40). In a group of eight patients plasma digoxin rose significantly after they were informed of the importance of taking their medicine regularly. Poor compliance with prescribed therapy was even documented in patients in cardiac failure.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 2
    ISSN: 1432-1041
    Keywords: prescribing habits ; psychotropics ; drug utilization ; methodology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The prescription of psychotropic drugs at a multidoctor district health centre in northern Sweden in 1973, was analysed by means of problemoriented medical records. Of the 22,000 inhabitants of the district 10,700 consulted the health centre. Psychotropic drugs were prescribed for 11.3% of the patients, corresponding to 5% of the inhabitants of the area. Sixty per cent of the patients received one psychotropic prescription and 90% not more than three. Two-thirds of prescriptions were for women. Hypnotics, sedatives and minor tranquillisers constituted 64% of all prescriptions, major tranquillisers 24% and antidepressants 12%. One fifth of the patients obtained drugs belonging to more than one of the major psychotropic groups during the year. Insomnia, psychoneurosis and depression made up two-thirds of the indications for psychotropic drug therapy. More than thirty different psychotropic drugs were prescribed for the two major indications. There was considerable variation in how the different doctors prescribed drugs for the same indication. Fifty-nine different drug products were prescribed, of which the commonest five constituted more than half of the total number. Individual doctors used from 22 to 38 different psychotropic drugs.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 3
    ISSN: 1432-1041
    Keywords: drug utilisation ; prescribing habits ; hypnotics ; sedatives ; minor tranquillisers ; defined daily doses ; therapeutic audit
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The utilisation of hypnotics, sedatives, and minor tranquillisers (HSmT) was studied by means of drug-delivery and hospital occupancy statistics for 1975–1977 in a Swedish university hospital. A total of 0.53 so-called defined daily doses (DDD)/bed-day were delivered in 1975, implying that every second patient might have regularly been prescribed HSmT. The benzodiazepines were predominant with 71% of the deliveries. Five major drugs accounted for 88%. The drug pattern and the range of DDD/bed-day (0.09–1.18) differed considerably between the departments. Drugs not recommended by the hospital's Pharmacy and Therapeutics Committee accounted only for 3% of deliveries. In a drug surveillance study performed in two medical wards, HSmT were prescribed for 43% of 274 patients. Drug delivery and prescription data were in broad agreement. Drug information activities in the hospital had a clearly discernable influence on the delivered DDD/bed-day. This measure is an inexpensive indicator of drug utilisation in a hospital and a suitable basis for therapeutic audit.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 4
    ISSN: 1432-1041
    Keywords: drug problems ; patient compliance ; adverse drug reactions ; interview ; pharmacokinetics ; inadequate therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The association between hospital admission and drug-related problems was evaluated in 285 consecutive admissions to two medical wards in a Swedish university hospital. Standardised definitions and criteria for causality were used. A drug-related problem was judged to have been the main reason for admission of 36 patients, and a strongly contributory reason for 9. These 45 patients comprised 16% of all patients, and 19% of those receiving medication prior to admission. For 19 patients the problem was considered to be failure to achieve the desired therapeutic effect. 11 of these 19 took less medication than prescribed, and an inadequate dose had been presented for the other 8 patients. In 26 patients there was an excessive or otherwise adverse effect. In 10 it was an intentional or accidental poisoning, and 16 had an adverse drug reaction. Non-compliance with the prescribed regimen caused almost half of the drug-related admissions: 11 took too little and 10 took too much of the prescribed drugs. The majority of the other problems could probably have been prevented by better application of pharmacokinetic principles to the prescribing.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 5
    ISSN: 1432-1041
    Keywords: drug epidemiology ; prescription forgeries ; substance abuse ; psychotropic drugs ; analgesics ; benzodiaepines
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Data on forged prescriptions in Sweden in 1982–1986 were studied as an indicator in an epidemiological survey of medication abuse. The annual number of prescription forgeries doubled during the 5-year period. Psychotropic drugs accounted for 62% and analgesics for 25% of all forgeries. Benzodiazepines were the major single drug group, comprising 52% of all forgeries during the period. The major benzodiazepines on the market in Sweden (diazepam, oxazepam, nitrazepam and flunitrazepam) were the subject of largest number of forgeries. When calculated in relation to the utilization (either total sales or the number of prescriptions), the analgesics codeine, pentazocine and ketobemidone were clearly at the head of the list, suggesting greater abuse liability of these drugs. It is suggested that the data on forged prescriptions can be used as a “signalling mechanism” in epidemiological surveillance of medication abuse, aimed at detecting changes in the prevalence as well as in the pattern of abuse.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 6
    ISSN: 1432-1041
    Keywords: Psychotropic drugs ; drug utilisation ; geographical differences ; prescribing habits
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Marked differences in the utilisation of psychotropic drugs between the three major urban areas in Sweden were recorded from four sources of information: drug supplies from wholesalers to pharmacies, drug supplies to hospitals for in-patient use, drugs sold on prescription for out-patient use, and out-patient consultation and drug prescribing as recorded by physicians. The total sales of psychotropics in the counties of Gothenburg (110,8 defined daily doses per 1000 inhabitants per day) and Malmö (102,1) were much higher than in the county of Stockholm (73,4), with about 25% of the difference being accounted for by diazepam. Differences in the total sales of psychotropics were not explained by any differences in hospital sales, which amounted to about 10% in all counties. Prescription sales differed due to the higher average number of DDD (defined daily doses) per prescription in Gothenburg and Malmö than in Stockholm (total psychotropics 8 and 15%, respectively), and especially because of the higher number of prescriptions per inhabitant (about 40 and 30–35%, respectively). There was no substantial difference in the pattern of diagnoses between areas, but there was a noticeable difference with regard to prescriber category, as psychiatrists accounted for more of the prescriptions in Stockholm than in Gothenburg and Malmö. The results raise questions about over- and under-treatment of mental disorders and about abuse of drugs. In order to explain the geographical differences in psychotropic drug sales morbidity patterns and prescribing practices should be further explored.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 7
    ISSN: 1432-1041
    Keywords: Diabetes ; antidiabetic drugs ; drug utilization ; prescribing habits ; geographical differences ; methodology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary In a comparison of three European countries Sweden utilized more antidiabetic drugs than Northern Ireland and Norway. Swedish wholesale figures for a quarter of a year used for the comparison were based on “daily doses”/1000 inhabitants/day. In order to validate the Swedish figures, a defined geographical area was investigated in 1972–1973, the island of Gotland with 54000 inhabitants. Antidiabetic drugs distributed on a wholesale basis were compared with those distributed on a prescription basis. Additional information was gathered (interviews, questionnaires, hospital records etc.) from a sample of patients (n=54) and their prescribing doctors (n=37). There was good agreement between the wholesale and prescription figures for oral antidiabetic drugs over a three month period (30.0 vs 29.8 “daily doses”/1000 inhabitants/day), but this did not apply to insulin (5.9 vs 7.2) unless a longer time period was studied. The average daily doses prescribed were higher than the theoretically derived “daily doses”. Combination antidiabetic drug therapy was preseribed for 28% of the patients. Thirteen different oral antidiabetics were issued during the study period, four of which constituted 90% of the total. Phenformin, the second most commonly prescribed oral antidiabetic drug was prescribed by 33 doctors, and metformin was prescribed by only 14 doctors. Few patients were treated with diet alone and few doctors could obtain assistance from a dietician. There was little or no evidence that patients failed to comply with the prescriptions, but by contrast they adhered poorly to written dietary instructions.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 8
    ISSN: 1432-1041
    Keywords: chlorpropamide ; diabetes ; drug utilisation ; patient compliance ; diet ; plasma concentration ; maturity onset diabetes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Serum chlorpropamide concentrations (s-CPA) were determined and related to clinical findings in 83 outpatients with maturity onset diabetes. The daily doses of CPA (mg/kg) varied six-fold, but s-CPA ranged 18-fold between the patients. There was a significant correlation between dose and s-CPA (r=0.61), which rose to 0.75 in the 30 patients who had prescribed no other drugs. Patients given other drugs concomitantly were over-represented amongst subjects with extreme values of apparent plasma clearance of CPA. There was no correlation either between serum creatinine or age and s-CPA. Of the 83 patients 40 (48%) had acceptable blood and urinary glucose values according to our criteria; but as 17 were overweight, only 23 patients (28%) had acceptable clinical control. Of the remaining 60 patients, too low a dose was being given to only 12, and dietary failure was the most probable explanation in the others. Thirteen patients (16%) probably did not need CPA. It is likely that this is a partial explanation for the high utilisation of oral antidiabetic drugs in Sweden. There was no general correlation between dose or s-CPA and blood glucose values, but analysis of s-CPA may still be of value in explaining unexpected changes in clinical control.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 9
    ISSN: 1432-1041
    Keywords: hypertension ; hypertensive therapy ; drug utilization ; therapeutic traditions ; international differences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary A questionnaire survey based on hypertension case histories was performed among a representative sample of 400 GP's and hospital doctors in Northern Ireland, Norway and Sweden, countries having markedly different utilization of antihypertensive drugs. We found a greater propensity to start antihypertensive drug treatment in Northern Ireland than in Norway and Sweden. This was true both in mild diastolic and isolated systolic hypertension. Yet the utilization of antihypertensive drugs in Sweden is about 60% higher than in Northern Ireland and 30% higher than in Norway. Swedish physicians preferred beta-blockers as their first choice to a greater extent than physicians in Northern Ireland and Norway who selected thiazides more often. In general, the choice of drugs agreed with the sales and prescribing patterns in the three countries. Besides providing more insight in therapeutic traditions the study indicates that the lower prescribing of antihypertensive drugs in Northern Ireland, and to some extent in Norway, compared to Sweden, might be due to differences in true or apparent morbidity.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 10
    ISSN: 1432-1041
    Keywords: Key words Drug utilisation ; Prescribing habits
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objectives: To describe a simple method for assessing the quality of drug prescribing. Methods: We tested the idea that the number of drugs accounting for 90% of drug use – drug utilization 90% (DU90%) – may serve as an indicator of the quality of drug prescribing. We ranked the drugs by volume of defined daily doses (DDD) and determined how many drugs accounted for the DU90% segment. We also compared this segment with the pharmacotherapeutic guidelines issued by the Regional (local) Drug Committee to determine the adherence to its recommendations (index of adherence). The cost per DDD within the DU90% segment and for the remaining 10% was also calculated. The utilization of drugs based on prescriptions purchased during April 1995 was determined for 24 primary health care (PHC) centres in southwestern Stockholm. Results: The number of different products, defined as all products marketed under a single brand name within an ATC (anatomic therapeutic chemical) category, in the DU90% segment varied twofold (81–164) between the 24 PHC centres. Differences in the number of GPs per PHC centre accounted for a third of this variation. The compliance with the Drug Committee recommendations varied between 54% and 78%. There was no relationship between the number of products accounting for the DU90% segment and the adherence to local prescription guidelines, i.e. prescribing more products did not increase the adherence. The costs for the DU90% drugs varied from 2.26 SEK/DDD in one PHC centre to 3.75 in another one, with an average cost of 2.87 SEK/DDD, while for the remaining 10% it was the double (6:54 SEK/DDD). In all, the DU90% drugs made up 80.8% of the total cost as compared with 19.2% for the remaining 10%. In the DU90% segment, there was no clear relationship between adherence to the guidelines and the cost/DDD, i.e. following the evidence-based guidelines appeared to provide a higher quality of prescribing rather than cheaper prescribing. Conclusions: The DU90% is an inexpensive, flexible, and simple method for assessing the quality of drug prescribing in routine health care. The number of products in the DU90% segment and adherence to prescription guidelines may serve as general quality indicators. The method may be adapted to provide comparative data between PHC centres, hospitals, regions etc. that may be cross-sectional and longitudinal. Other quality criteria, specific for each class of drugs, should complement these general indicators.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...