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  • 1
    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.
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  • 2
    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.
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  • 3
    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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  • 4
    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.
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  • 5
    ISSN: 1432-1041
    Keywords: compliance ; prescribing habits ; drug utilisation ; age effect ; multiple therapies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The drug history of 285 consecutive patients admitted to two medical wards of a Swedish university hospital was investigated. In 30 cases (11%) no information about current drug therapy could be obtained from the patients themselves, and in further 21 (7%) additional drugs from other sources were discovered. Current drug therapy of 234 patients (82%) was identified, of whom 217 had medicines supplied by prescription and 52 used drugs bought over the counter. The medication was “chronic” for 85% of the prescribed drugs, and 18% were prescribed to be taken as required. Significantly more women than men were taking medicines, but, amongst the users, there was no significant difference in the number of drugs taken by men or women. The average number of drugs prescribed for the 217 patients was 3.7, more being prescribed for the older patients. Cardiovascular and psychotropic medicines were the agents most commonly prescribed. Digoxin was prescribed for 65 patients. The mean daily dose was 0.20 mg, and it was reduced for older patients and for those with elevated serum creatinine. Twelve patients (19%) had no measurable digoxin in their plasma; the median concentration was 1.15 nmol/l. Ten of 32 patients (31%) had a significant change in their plasma digoxin concentration after supervised drug intake in hospital, indicating previous irregular intake of digoxin. Compliance with the prescribed drug regimen was evaluated from interviews of 151 patients. Of them, 59 (39%) were classified as having been non-compliant for half their drugs during the last two days prior to admission. Non-compliance was reported significantly more often by patients who were aged 65 years or more, and who had more than three drugs prescribed for regular intake. The number of drugs prescribed did not seem to influence compliance in patients under 65 years of age. Significantly more doses were reported to be missed for drugs meant to be taken thrice daily (31%), than for those with once (18%) or twice (20%) daily dosage schedule. The difference between once and twice daily schedules was not significant.
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