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  • 1
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Social Science & Medicine 29 (1989), S. 1363-1366 
    ISSN: 0277-9536
    Keywords: drug consumption ; drug prices ; health care expenditure ; health economics ; prescribing behaviour
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1041
    Keywords: Sulfapral ; nitrofurantoin ; adverse reaction ; skin ; lung ; monitoring scheme ; Sweden
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Adverse reactions reported to the Swedish Adverse Drug Reaction Committée concerning Sulfapral (a sulphonamide combination for urinary tract infections) and nitrofurantoin were remarkably similar. The commonest hypersensitivity reactions were in skin and lung. During the 10-year period 1966–75 reactions to the sulphonamide were fewer (n=327) than those reported for nitrofurantoin (n=781), but the former appeared to carry a higher mortality rate — 4.6 per cent of reported sulphonamide reactions were fatal as compared to only 1.0 per cent for nitrofurantoin (P〈0.001). The number of reactions to the sulphonamide tended to remain constant, whereas those to nitrofurantoin increased rapidly, both absolutely as well as relative to sales of the drug.
    Type of Medium: Electronic Resource
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  • 3
    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
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  • 4
    ISSN: 1432-1041
    Keywords: oestrogens ; endometrial cancer ; cohort study ; drug surveillance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary A Swedish study of the risk of endometrial cancer associated with oestrogen treatment was started in 1977. A prospective design was chosen and a cohort of 23, 233 women receiving oestrogen medication was collected over a three-year period. Cohort members were recruited on the basis of prescription forms for oestrogens produced by all 120 pharmacies in a defined geographical region, resulting in comprehensive coverage of that region. A questionnaire study of a random sample (1/30) of the cohort permitted mapping of confounding factors, estimation of drug compliance and detailed characterization of oestrogen and progestagen exposures. Efficient follow-up of the cohort members was achieved by linkage of identity numbers of cohort members and those of all incident cases of endometrial cancer in the region. The expected outcome was calculated on the basis of accumulated person-years of observation in the entire cohort — and in subgroups — and age-specific incidence rates of endometrial cancer in the reference population. The present design may be generally useful for post-marketing studies of the association between drug use and side-effects.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1041
    Keywords: Post-marketing surveillance ; oral contraceptives ; record-linkage ; epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The Department of Drugs of the Swedish National Board of Health and Welfare undertook a study of the possibilities of a new scheme for post-marketing surveillance by means of prescription and register based epidemiological studies, primarily of combined oral contraceptives (COC). Based on available data on COC usage patterns and incidence rates of the disease at study, it was estimated that study periods, including the necessary time periods for disease development and generation of a sufficient number of cases, would amount to at least 1 to 13 years for cardiovascular outcomes and 8 to 17 years for reproductive cancers. Prospective and unbiased exposure ascertainment would be the most important advantage. However, delay in follow up, the need for extensive individual questionnaire probing and fear of violation of personal integrity could adversely affect the feasibility of the scheme. Chiefly on the grounds of the extended study periods and magnitude of the necessary infrastructure, it was not judged cost-effective to pursue such a scheme for COC exposure only. It was, however, suggested that it would be considered for epidemiological surveillance of other drugs that are commonly used and for which short term and frequent serious side effects are expected, as for instance lipid lowering compounds, beta-blockers, bensodiazepines and other psychotropic drugs.
    Type of Medium: Electronic Resource
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  • 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
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  • 7
    ISSN: 1432-1041
    Keywords: Diabetes ; insulin ; sulphonylureas ; biguanides ; drug utilization ; geographical differences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The consumption of insulin and oral antidiabetic drugs was measured at the gross sales level in Sweden and Norway and at the prescription level in Northern Ireland. “Agreed daily doses” were used as units of comparison, which defined as follows: insulin 40 I.U., tolbutamide 1 g, acetohexamide 500 mg etc. Consumption was expressed as the number of “agreed daily doses” per 1,000 inhabitants per day. This provided a rough estimate of the number of subjects for whom the drug had been prescribed per 1,000 population. The data were collected during the three months April – June 1971. Marked differences in the consumption of antidiabetic drugs were found between the three countries and also between areas within each country. The consumption of insulin was similar in Norway and Northern Ireland (3.5 and 3.9 agreed daily doses per 1,000 inhabitants per day), but almost twice as high in Sweden. In Norway much lower use was found in certain rural areas. The variation in the consumption of oral antidiabetic drugs was even more marked. Surprisingly, consumption was considerably higher in Sweden (15.8) than in the nearby Norway (7.3), and was even lower in Northern Ireland (4.3). The major use was of sulphonylureas, especially chlorpropamide. Within the countries there was marked regional variation in the choice of individual biguanides and sulphonylureas. The data are discussed in relation to such factors as the incidence of diabetes, the sole use of dietary treatment etc. It is concluded that studies in depth, which link the actual use of drugs by patients to diagnosis, diabetic symptoms and clinical outcome of treatment are necessary in order to explore the reasons behind the marked geographical differences and to define a rational drug policy. However, the methods described in the study may be used for early detection of gross national differences in drug utilization, the further investigation of which may reveal to be of great public health interest.
    Type of Medium: Electronic Resource
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