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Titolo:
Lack of adherence to lipid-lowering drug treatment. A comparison of utilization patterns in defined populations in Funen, Denmark and Bologna, Italy
Autore:
Larsen, J; Vaccheri, A; Andersen, M; Montanaro, N; Bergman, U;
Indirizzi:
Odense Univ, Univ So Denmark, Dept Clin Pharmacol, DK-5000 Odense C, Denmark Odense Univ Odense Denmark C t Clin Pharmacol, DK-5000 Odense C, Denmark Odense Univ, Univ So Denmark, Res Unit Gen Practice, DK-5000 Odense, Denmark Odense Univ Odense Denmark DK-5000 Gen Practice, DK-5000 Odense, Denmark Univ Bologna, Dept Pharmacol, Interuniv Res Ctr Pharmacoepidemiol, Bologna, Italy Univ Bologna Bologna Italy iv Res Ctr Pharmacoepidemiol, Bologna, Italy Huddinge Univ Hosp, Karolinska Inst, Dept Clin Pharmacol, S-14186 Huddinge, Sweden Huddinge Univ Hosp Huddinge Sweden S-14186 col, S-14186 Huddinge, Sweden
Titolo Testata:
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
fascicolo: 5, volume: 49, anno: 2000,
pagine: 463 - 471
SICI:
0306-5251(200005)49:5<463:LOATLD>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
DISCONTINUATION; PRAVASTATIN; FINLAND; RATES;
Keywords:
individualized prescription databases; international comparison; lipid-lowering drug utilization; persistence;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Larsen, J Odense Univ, Univ So Denmark, Dept Clin Pharmacol, Winslowpk 19,DK-5000 Odense C, Denmark Odense Univ Winslowpk 19 Odense Denmark C 000 Odense C, Denmark
Citazione:
J. Larsen et al., "Lack of adherence to lipid-lowering drug treatment. A comparison of utilization patterns in defined populations in Funen, Denmark and Bologna, Italy", BR J CL PH, 49(5), 2000, pp. 463-471

Abstract

Aims The objective was to explore differences in lipid-lowering drug (LLD)prescribing in Italy and Denmark. Methods We used two geographical areas with computerized drug prescriptionrecords in defined populations, one in Funen, Denmark with 500 000 inhabitants, the other in Bologna, Italy with 400 000 inhabitants. Prescriptions for patients who had purchased a LLD from 1994 until 1996 were retrieved as well as coprescriptions of antidiabetic and cardiovascular drugs as markersfor diabetes and cardiovascular disease. Only patients surviving and remaining in the area were included. Compliance was defined as percentage of DDDs purchased divided by the number of days within the time window. The limitbetween good and poor compliance was set at 82%. Results In Bologna, LLD consumption measured in DDD increased by 41% and in Funen by 129%. Annual prevalence increased from 36.9 to 46.3 users/1000 inhabitants from 1994 to 1996 and from 3.2 to 6.6 users/1000 inhabitants in Bologna and Funen, respectively. From 1995 to 1996, the incidence of use decreased slightly in Bologna from 19.3 to 18.8/1000 inhabitants/year, whereas in Funen the incidence increased from 1.8 to 2.3/1000 inhabitants/year. In Bologna 48% and in Funen 91% of users persisted with treatment for 2 years or longer. In Bologna, 7% and in Funen 45% were good compliers. In Bologna, 61% and in Funen, 72% received other drugs indicating cardiovascular or diabetic comorbidity. Conclusions Patterns of use differed substantially between the two areas. In contrast with Funen, where long-term use was common, Bologna LLD use wassporadic. Based on a higher rate of coprescription, LLDs seemed to be usedfor secondary prevention to a higher extent in Funen than in Bologna. In Funen it appeared that the correct patients, but an insufficient number of them, were being treated adequately according to guidelines. The higher discontinuation rate of lipid lowering drugs in the Bologna area indicates thata large proportion of patients use these drugs for too short a period of time to benefit from treatment. Since society's health care resources are Limited it is difficult to justify public funding of these medications without at the same time giving appropriate attention to these problems.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 06:55:51