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Maillard O, Bun R, Laanani M, Verga-Gérard A, Leroy T, Gault N, Estellat C, Noize P, Kaguelidou F, Sommet A, Lapeyre-Mestre M, Fourrier-Réglat A, Weill A, Quantin C, Tubach F. Use of the French National Health Data System (SNDS) in pharmacoepidemiology: A systematic review in its maturation phase. Therapie 2024:S0040-5957(24)00065-9. [PMID: 38834394 DOI: 10.1016/j.therap.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/14/2024] [Accepted: 05/16/2024] [Indexed: 06/06/2024]
Abstract
AIM OF THE STUDY The French National Health Data System (SNDS) comprises healthcare data that cover 99% of the population (over 67 million individuals) in France. The aim of this study was to present an overview of published pharmacoepidemiological studies using the SNDS in its maturation phase. METHODS We conducted a systematic literature review of original research articles in the Pubmed and EMBASE databases from January 2012 until August 2018. RESULTS A total of 316 full-text articles were included, with an annual increase over the study period. Only 16 records were excluded after screening because they did not involve the SNDS but other French healthcare databases. The study design was clearly reported in only 66% of studies of which 57% were retrospective cohorts and 22% cross-sectional studies. The reported study objectives were drug utilization (65%), safety (22%) and effectiveness (9%). Almost all ATC groups were studied but the most frequent ones concerned the nervous system in 149 studies (49%), cardiovascular system drugs in 104 studies (34%) and anti-infectives for systemic use in 50 studies (16%). CONCLUSION The SNDS is of growing interest for studies on drug use and safety, which could be conducted more in specific populations, including children, pregnant women and the elderly, as these populations are often not included in clinical trials.
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Affiliation(s)
- Olivier Maillard
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; Department of Public Health and Research, CHU de La Réunion, 97400 Saint-Pierre, Ile de La Reunion, France; Clinical Investigation Center, INSERM CIC 1410, CHU de La Réunion, 97400 Saint-Pierre, Ile de La Reunion, France.
| | - René Bun
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; Department of Public Health and Research, CHU de La Réunion, 97400 Saint-Pierre, Ile de La Reunion, France; Clinical Investigation Center, INSERM CIC 1410, CHU de La Réunion, 97400 Saint-Pierre, Ile de La Reunion, France
| | - Moussa Laanani
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; French National Health Insurance, 75000 Paris, France
| | - Amandine Verga-Gérard
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; INSERM, CIC-EC 1433, 54100 Nancy, France
| | - Taylor Leroy
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; INSERM, CIC-EC 1433, 54100 Nancy, France
| | - Nathalie Gault
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; INSERM, CIC-EC 1425, hôpital Bichat, 75018 Paris, France
| | - Candice Estellat
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; Sorbonne Université, INSERM, institut Pierre-Louis d'épidémiologie et de Santé publique, AP-HP, hôpital Pitié-Salpêtrière, département de Santé publique, centre de pharmacoépidémiologie (Cephepi), CIC-1901, 75000 Paris, France
| | - Pernelle Noize
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; Université de Bordeaux, INSERM, BPH, U1219, Team AHeaD, CHU de Bordeaux, pôle de santé publique, service de pharmacologie médicale, 33000 Bordeaux, France
| | - Florentia Kaguelidou
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; INSERM, CIC-EC 1426, Department of Pediatric Pharmacology and Pharmacogenetics, Clinical Investigations Center, hôpital Robert-Debré, 75019 Paris, France; UMR-1123, ECEVE, université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France
| | - Agnès Sommet
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; Service de pharmacologie médicale et clinique, faculté de médecine, CIC 1436, CHU, université de Toulouse, 31000 Toulouse, France
| | - Maryse Lapeyre-Mestre
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; Service de pharmacologie médicale et clinique, faculté de médecine, CIC 1436, CHU, université de Toulouse, 31000 Toulouse, France
| | - Annie Fourrier-Réglat
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; Université de Bordeaux, INSERM, BPH, U1219, Team AHeaD, CHU de Bordeaux, pôle de santé publique, service de pharmacologie médicale, 33000 Bordeaux, France
| | - Alain Weill
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; Epiphare (French National Medicines Agency ANSM and French National Health Insurance CNAM), 93200 Saint-Denis, France
| | - Catherine Quantin
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; Service de biostatistiques et d'information médicale (DIM), CHU Dijon Bourgogne, INSERM, université de Bourgogne, CIC 1432, module épidémiologie clinique, 21000 Dijon, France; Université Paris-Saclay, UVSQ, Inserm, CESP, 94807 Villejuif, France
| | - Florence Tubach
- Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; Sorbonne Université, INSERM, institut Pierre-Louis d'épidémiologie et de Santé publique, AP-HP, hôpital Pitié-Salpêtrière, département de Santé publique, centre de pharmacoépidémiologie (Cephepi), CIC-1901, 75000 Paris, France
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Cruz AJS, Martins MAP, Batista VS, de Aguilar Penido HP, Santos JS, dos Santos TR, Sohn W, de Castilho LS, Abreu MHNG. Dental Pain Medication Prescriptions in Minas Gerais, Brazil (2011-2021): A Time-Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6795. [PMID: 37754654 PMCID: PMC10531368 DOI: 10.3390/ijerph20186795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 09/28/2023]
Abstract
To describe trends of dentist-prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics, from January 2011 to December 2021, as well as to examine the relationship between these trends and characteristics of public oral health services in Minas Gerais, Brazil. In this time-series analysis, all drugs were classified according to the Anatomical Therapeutic Chemical classification system. Drugs categorized as NSAIDs (M01A), and other analgesics and antipyretics (N02B) were included for analysis. The outcome was the number of Defined Daily Doses (DDDs)/1000 inhabitants/year for NSAIDs and analgesics in each town. Covariates referred to characteristics of public oral health services, such as coverage, estimates of dental procedures, and frequency of toothache. Linear time-series regression models were used to determine the influence of covariates on the outcome. Overall, there were 58,482 prescriptions of NSAIDs recorded in thirty-eight towns, while 47,499 prescriptions of analgesics in forty-three towns. For each year, there was a 0.38 (p < 0.001), and 0.28 (p < 0.001) increase in the average log of DDD/1000 inhabitants/year for NSAIDs and analgesics, respectively. A positive association was detected between toothache (p < 0.001) and the prescription of NSAIDs. Over the eleven years, there was a general rising trend in the prescriptions. Toothache was the only characteristic of public oral health services associated with the prescription rates of NSAIDs, implying that as the frequency of toothaches increase, so do the prescriptions of NSAIDs in the studied towns.
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Affiliation(s)
- Alex Junio Silva Cruz
- Graduate Dental Program, School of Dentistry, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte 31270901, Brazil;
| | | | - Victor Santos Batista
- Undergraduate Dental Program, School of Dentistry, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte 31270901, Brazil;
| | - Henrique Pereira de Aguilar Penido
- Undergraduate Math Program, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte 31270901, Brazil;
| | - Jacqueline Silva Santos
- Oral Health Department for the State of Minas Gerais, Universidade Federal de Minas Gerais, Belo Horizonte 31630-901, Brazil;
| | - Thiago Rezende dos Santos
- Department of Statistics, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte 31270901, Brazil;
| | - Woosung Sohn
- Discipline of Population Oral Health, School of Dentistry, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Lia Silva de Castilho
- Department of Operative Dentistry, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, Belo Horizonte 31270901, Brazil;
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Chen TC, Wettermark B, Steinke D, Caughey GE, Tadrous M, Wirtz VJ, Chen LC. Feasibility and validity of using healthcare databases to conduct cross-national comparative studies of opioid use, its determinants and consequences. Pharmacoepidemiol Drug Saf 2023; 32:1021-1031. [PMID: 36942801 DOI: 10.1002/pds.5618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 02/28/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE A cross-national comparative (CNC) study about opioid utilization would allow the identification of strategies to improve pain management and mitigate risk. However, little is known about the accessibility and validity of information in healthcare databases internationally. This study aimed to identify the feasibility of using healthcare databases to conduct a CNC study of opioid utilization and its associated consequences. METHODS A cross-sectional survey was launched in March 2018, including experts interested in CNC studies comparing opioid utilization by purposeful sampling. An electronic survey was used to collect database characteristics, medicine information, and linkage information of each aggregate-level dataset (AD) and individual patient-level dataset (IPD). RESULTS Overall, participants from 21 geographical regions reported 18 ADs and 19 IPDs. Information on dispensed medications is available from 17 ADs and 17 IPDs. Of the 16 ADs that include primary care settings, only 9 ADs can obtain information from secondary care settings. Fourteen IPDs included patients' characteristics or could be retrieved from linkage databases. Although most ADs are publicly accessible (n = 13), only five IPDs can be accessed without extra cost. CONCLUSION Most ADs could be used to report opioid utilization in a primary care setting. IPDs with linkage databases should be applied to identify potential determinants, clinical outcomes, and policy impact. Data access restrictions and governance policies across jurisdictions can be challenging for timely analysis and require further collaboration.
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Affiliation(s)
- Teng-Chou Chen
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Björn Wettermark
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
- Pharmacy Center, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Douglas Steinke
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Gillian E Caughey
- Registry of Senior Australians, South Australian Health and Medical Research Institute and Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Mina Tadrous
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Veronika J Wirtz
- Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Li-Chia Chen
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Leal LF, Osorio-de-Castro CGS, de Souza LJC, Ferre F, Mota DM, Ito M, Elseviers M, Lima EDC, Zimmernan IR, Fulone I, Carvalho-Soares MDL, Lopes LC. Data Sources for Drug Utilization Research in Brazil-DUR-BRA Study. Front Pharmacol 2022; 12:789872. [PMID: 35115935 PMCID: PMC8805708 DOI: 10.3389/fphar.2021.789872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022] Open
Abstract
Background: In Brazil, studies that map electronic healthcare databases in order to assess their suitability for use in pharmacoepidemiologic research are lacking. We aimed to identify, catalogue, and characterize Brazilian data sources for Drug Utilization Research (DUR). Methods: The present study is part of the project entitled, “Publicly Available Data Sources for Drug Utilization Research in Latin American (LatAm) Countries.” A network of Brazilian health experts was assembled to map secondary administrative data from healthcare organizations that might provide information related to medication use. A multi-phase approach including internet search of institutional government websites, traditional bibliographic databases, and experts’ input was used for mapping the data sources. The reviewers searched, screened and selected the data sources independently; disagreements were resolved by consensus. Data sources were grouped into the following categories: 1) automated databases; 2) Electronic Medical Records (EMR); 3) national surveys or datasets; 4) adverse event reporting systems; and 5) others. Each data source was characterized by accessibility, geographic granularity, setting, type of data (aggregate or individual-level), and years of coverage. We also searched for publications related to each data source. Results: A total of 62 data sources were identified and screened; 38 met the eligibility criteria for inclusion and were fully characterized. We grouped 23 (60%) as automated databases, four (11%) as adverse event reporting systems, four (11%) as EMRs, three (8%) as national surveys or datasets, and four (11%) as other types. Eighteen (47%) were classified as publicly and conveniently accessible online; providing information at national level. Most of them offered more than 5 years of comprehensive data coverage, and presented data at both the individual and aggregated levels. No information about population coverage was found. Drug coding is not uniform; each data source has its own coding system, depending on the purpose of the data. At least one scientific publication was found for each publicly available data source. Conclusions: There are several types of data sources for DUR in Brazil, but a uniform system for drug classification and data quality evaluation does not exist. The extent of population covered by year is unknown. Our comprehensive and structured inventory reveals a need for full characterization of these data sources.
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Affiliation(s)
- Lisiane Freitas Leal
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | | | | | - Felipe Ferre
- Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Marcia Ito
- Professional Master's Program in Productive Systems, Centro Estadual de Educação Tecnológica Paula Souza, São Paulo, Brazil
| | | | | | - Ivan Ricardo Zimmernan
- Faculdade de Ciências da Saúde Campus Darcy Ribeiro, University of Brasília, Brasília, Brazil
| | - Izabela Fulone
- Graduate Pharmaceutical Science, University of Sorocaba, Sao Paulo, Brazil
| | | | - Luciane Cruz Lopes
- Graduate Pharmaceutical Science, University of Sorocaba, Sao Paulo, Brazil
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Data transparency for building a stronger healthcare system: A case study from Argentinean administrative drug utilization data sources. Salud Colect 2021; 17:e3339. [PMID: 34105332 DOI: 10.18294/sc.2021.3339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/05/2021] [Indexed: 11/24/2022] Open
Abstract
In order to compile an inventory of national data sources for drug utilization research (DUR) in Argentina and to verify publicly available data sources, we performed a cross-sectional study that sought to identify national and provincial databases of drug use. In July 2020, we searched the websites of government institutions, carried out a systematic query of bibliographic databases for "drug utilization research" conducted in Argentina, and conducted a survey with local experts. Data collected included: the institution responsible for the database, population covered, accessibility, source of the data, healthcare setting, geographic information, and whether data were individual or aggregated. Descriptive analyses were then performed. We identified 31 data sources for DUR; only one was publicly and conveniently accessible. Five published aggregated data and provide more detailed access by formal request. Only seven sources (23%) reported national data, and most (n=29) included only data from the public healthcare sector. Although data sources for DUR have been found in Argentina, limited access by researchers and policymakers is still an significant obstacle. Increasing health data transparency by making data sources publicly available for the purpose of analyzing public health information is crucial for building a stronger health system.
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Prescription, over-the-counter (OTC), herbal, and other treatments and preventive uses for COVID-19. ENVIRONMENTAL AND HEALTH MANAGEMENT OF NOVEL CORONAVIRUS DISEASE (COVID-19 ) 2021. [PMCID: PMC8237643 DOI: 10.1016/b978-0-323-85780-2.00001-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The current COVID-19 pandemic has spread rapidly worldwide and has challenged fragile health care systems, vulnerable socioeconomic conditions, and population risk factors, and has led to an overwhelming tendency to misuse prescription drugs and self-medication with prescription drugs, over-the-counter (OTC) drugs, herbals products, and unproven chemicals as a desperate preventive or curative measure for COVID-19. In this chapter, we present the legislative differences between prescription drugs, OTC drugs, and herbals. Various approved and nonapproved prescription and OTC drugs as symptomatic treatment for COVID-19 are listed and evaluated based on their reported efficacy, safety, and toxicological profile. We also present the various herbal products that are currently studied and used as treatment and preventive for COVID-19. The efficacy, toxicology profile, safety, and legal issues of some speculative preventive and treatment options against COVID-19, such as Miracle Mineral Solution (MMS), chlorine dioxide solution (CDS), colloidal silver, and hydrogen peroxide is presented. The chapter also emphasizes the specific strategies that need to be implemented to guide the population in the effective and safe use of prescribed medications, such as the Medication Therapy Management or Pharmaceutical Care process. Finally, this chapter aims to provide a deeper insight into the lack of health literacy in the population and the effect that drug utilization research (DUR) has in the decision making of health authorities and general public. We aim to provide the current information about the various treatment and preventive options used for COVID-19.
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Cruz AJSD, Santos JS, Pereira JÚnior EA, Ruas CM, Mattos FDF, Castilho LSD, Abreu MHNG. Prescriptions of analgesics and anti-inflammatory drugs in municipalities from a Brazilian Southeast state. Braz Oral Res 2020; 35:e011. [PMID: 33331405 DOI: 10.1590/1807-3107bor-2021.vol35.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/28/2020] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to describe dental prescriptions of non-steroidal anti-inflammatory drugs (NSAID), opioids, and analgesics dispensed by the Brazilian National Health System (BNHS, SUS in Portuguese) of a Southeastern state from January to December 2017, and to analyze their association with socioeconomic and oral health care services' characteristics at municipal level. Data were collected from the Brazilian Integrated Pharmaceutical Care Management System. Medicines were grouped according to the Anatomical Therapeutic Chemical Classification System. The total number of Defined Daily Doses (DDD) and DDD per 1,000 inhabitants (inhab.) per year were presented and compared between groups of municipalities. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25.0. The total number of NSAID, opioids, and analgesics prescriptions was 70,747 and accounted for 354,221.13 DDD. The most frequently prescribed medicine was ibuprofen (n = 24,676; 34.88%). The number of dental practitioners in the BNHS per 1,000 inhab. (p < 0.001), first dental appointment coverage (p = 0.010), oral health teams per 1,000 inhab. (p=0.022), and the proportion of rural population (p = 0.014) were variables positively associated with the number of DDD of NSAID per 1,000 inhab. per year. Bolsa Família program coverage per 1,000 inhab. (p = 0.022) was negatively associated with NSAID prescription. Regarding analgesics, first dental appointment coverage (p=0.002) and Bolsa Família program coverage per 1,000 inhab. (p = 0.012) were positively associated with DDD per 1,000 inhab. per year. In conclusion, dental prescriptions of analgesics and NSAID in the BNHS were associated with socioeconomic and oral health care services' characteristics.
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Affiliation(s)
- Alex Júnio Silva da Cruz
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Graduate Programme in Dentistry, Belo Horizonte, MG, Brazil
| | - Jacqueline Silva Santos
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Graduate Programme in Dentistry, Belo Horizonte, MG, Brazil
| | | | - Cristina Mariano Ruas
- Universidade Federal de Minas Gerais - UFMG, School of Pharmacy, Department of Social Pharmacy, Belo Horizonte, MG, Brazil
| | - Flávio de Freitas Mattos
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Lia Silva de Castilho
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Operative Dentistry, Belo Horizonte, MG, Brazil
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Franco J, Vizcaya D. Availability of secondary healthcare data for conducting pharmacoepidemiology studies in Colombia: A systematic review. Pharmacol Res Perspect 2020; 8:e00661. [PMID: 32965783 PMCID: PMC7510335 DOI: 10.1002/prp2.661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022] Open
Abstract
Real-world evidence (RWE) is emerging as a fundamental component of the post-marketing evaluation of medicinal products. Even though the focus on RWE studies has increased in Colombia, the availability of secondary data sources to perform this type of research is not well documented. Thus, we aimed at identifying and characterizing secondary data sources available in Colombia. We performed a systematic literature review on PubMed, EMBASE, and VHL using a combination of controlled vocabulary and keywords for the concepts of electronic health records, epidemiologic studies and Colombia. A total of 323 publications were included. These comprised 123 identified secondary data sources including pharmacy dispensing databases, government datasets, disease registries, insurance databases, and electronic heath records, among others. These data sources were mostly used for cross-sectional studies focused on disease epidemiology in a specific population. Almost all databases (95%) contained demographic information, followed by pharmacological treatment (44%) and diagnostic tests (39%). Even though the database owner was identifiable in 94%, access information was only available in 44% of the articles. Only a pharmacy-dispensing database, local cancer registries, and government databases included a description regarding the quality of the information available. The diversity of databases identified shows that Colombia has a high potential to continue enhancing its RWE strategy. Greater efforts are required to improve data quality and accessibility. The linkage between databases will expand data pooling and integration to boost the translational potential of RWE.
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Salas M, Lopes LC, Godman B, Truter I, Hartzema AG, Wettermark B, Fadare J, Burger JR, Appenteng K, Donneyong M, Arias A, Ankrah D, Ogunleye OO, Lubbe M, Horne L, Bernet J, Gómez-Galicia DL, Del Carmen Garcia Estrada M, Oluka MN, Massele A, Alesso L, Herrera Comoglio R, da Costa Lima E, Vilaseca C, Bergman U. Challenges facing drug utilization research in the Latin American region. Pharmacoepidemiol Drug Saf 2020; 29:1353-1363. [PMID: 32419226 DOI: 10.1002/pds.4989] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 12/20/2019] [Accepted: 02/03/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE The International Society of Pharmacoepidemiology (ISPE) in collaboration with the Latin America Drug Utilization Research Group (LatAm DURG), the Medicines Utilization Research in Africa (MURIA) group, and the Uppsala Monitoring Center, is leading an initiative to understand challenges to drug utilization research (DUR) in the Latin American (LatAm) and African regions with the goal of communicating results and proposing solutions to these challenges in four scientific publications. The purpose of this first manuscript is to identify the main challenges associated with DUR in the LatAm region. METHODS Drug utilization (DU) researchers in the LatAm region voluntarily participated in multiple discussions, contributed with local data and reviewed successive drafts and the final manuscript. Additionally, we carried out a literature review to identify the most relevant publications related to DU studies from the LatAm region. RESULTS Multiple challenges were identified in the LatAm region for DUR including socioeconomic inequality, access to medical care, complexity of the healthcare system, limited investment in research and development, limited institutional and organization resources, language barriers, limited health education and literacy. Further, there is limited use of local DUR data by decision makers particularly in the identification of emerging health needs coming from social and demographic transitions. CONCLUSIONS The LatAm region faces challenges to DUR which are inherent in the healthcare and political systems, and potential solutions should target changes to the system.
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Affiliation(s)
- Maribel Salas
- Daiichi Sankyo, Inc, Basking Ridge, USA.,CCEB/CPeRT, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Luciane C Lopes
- Pharmaceutical Science graduate Course, Universidade de Sorocaba UNISO, Sao Paulo, Brazil
| | - Brian Godman
- Karolinska Institute, Stockholm, Sweden.,Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Gainesville, Glasgow, UK.,School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, South Africa
| | - Ilse Truter
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Nelson Mandela University, South Africa
| | | | - Bjorn Wettermark
- Clinical epidemiology & Clinical pharmacology, Karolinska Institutet, Stockholm, Sweden.,Department of Pharmacy, Disciplinary Domain of Medicine and Pharmacy, Uppsala University
| | - Joseph Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University College of Medicine, Ado-Ekiti, Nigeria
| | - Johanita R Burger
- Medicine Usage in South Africa (MUSA), North-West University, Potchefstroom, South Africa
| | - Kwame Appenteng
- Department of Epidemiology, Astellas Pharma US, Northbrook, IL
| | - Macarius Donneyong
- Pharmacy Practice and Science, College of Pharmacy, The Ohio State University, Columbus, Ohio
| | - Ariel Arias
- Centre for Biologics Evaluation, Health Canada, Ottawa, ON and Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada
| | | | - Olayinka O Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Martha Lubbe
- Medicine Usage in South Africa (MUSA), North-West University, Potchefstroom, South Africa
| | - Laura Horne
- Department of Epidemiology, Daiichi Sankyo, Inc, Basking Ridge, NJ
| | - Jorgelina Bernet
- School of Medicine, Cordoba National University, Cordoba, Argentina
| | - Diana L Gómez-Galicia
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Cuernavaca, México
| | | | | | - Amos Massele
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Luis Alesso
- School of Medicine, Cordoba National University, Cordoba, Argentina
| | | | - Elisangela da Costa Lima
- Observatorio de Vigilancia e Uso de Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ
| | - Carmen Vilaseca
- Colegio de Bioquimica y Farmacia, La Paz, Bolivia, Plurinational State
| | - Ulf Bergman
- Departments of Clinical Pharmacology and Pharmacoepidemiology, Karolinska Institutet, Karolinska University Hospital, Huddinge
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10
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Bustin J, Rojas G, O'Neill S, Sarasola D, Triskier F, Urtasun M, Cañás M, Mastai R, Demey I. What is happening with not recommended drugs for dementia in Argentina? Prescription patterns and direct costs analysis. Int J Geriatr Psychiatry 2020; 35:270-275. [PMID: 31755128 DOI: 10.1002/gps.5242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 11/07/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The only recommended pharmacological treatments for specific dementias are donepezil, galantamine, rivastigmine, and memantine (recommended drugs, RD). However, other drugs without recommendations (not recommended drugs, NRD) are often used to treat patients with cognitive impairment (CI) in Argentina. The INSSJyP is the largest health insurance in Argentina. The objective of this study is to analyze the prescription pattern, cost, and implications of NRD used for the treatment of CI in the INSSJyP. MATERIALS This is a retrospective, population-based study of the INSSJyP outpatients' prescriptions database for drugs usually prescribed for CI during 2015. These data were compared with the same database in 2009. The number of "prescriptions" always refers to dispensed packages. RESULTS A total of 3 255 438 packages of drugs usually indicated for CI were prescribed during 2015: 1 912 476 packages of RD (59%) and 1 342 962 packages of NRD (41%).Comparing the results with those obtained in 2009, there is a 148% gross increase in the prescription of both RD and NRD for CI, although the rates/1000 affiliates/year show a lesser rise for NRD (70.1%) compared to RD (103.9 %).The expenditure on CI drugs prescribed during 2015 was 77 million USD. NRD cost represented approximately 20 million USD. CONCLUSION Inappropriate drug use increases health costs in developing countries. We found a high number of patients with a probable diagnosis of CI treated with NRD. It is extremely relevant that all the healthcare professionals can update their knowledge and modify behavioral insights about appropriate prescription for specific dementias.
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Affiliation(s)
- Julian Bustin
- INSSJYP, Buenos Aires, Argentina.,INCyT, Buenos Aires, Argentina.,INECO, Buenos Aires, Argentina
| | - Galeno Rojas
- Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina.,Fundación Favaloro, Buenos Aires, Argentina.,Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Fabian Triskier
- INSSJYP, Buenos Aires, Argentina.,INECO, Buenos Aires, Argentina
| | - Martín Urtasun
- Área Farmacología Fundación FEMEBA, La Plata, Argentina.,Instituto de Ciencias de la Salud-UNAJ, La Plata, Argentina
| | - Martín Cañás
- Área Farmacología Fundación FEMEBA, La Plata, Argentina.,Instituto de Ciencias de la Salud-UNAJ, La Plata, Argentina
| | | | - Ignacio Demey
- Hospital Británico de Buenos Aires, Buenos Aires, Argentina.,FLENI, Buenos Aires, Argentina
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11
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Durán CE, Elseviers M, Vander Stichele R, Rottey S, Christiaens T. Sharp rise in the expenditures of targeted drugs in Ecuador: five-year (2010-2014) consumption of oncologic drugs in public and private hospitals. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2018. [DOI: 10.1111/jphs.12221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Carlos E. Durán
- Heymans Institute of Pharmacology; Ghent University; Gent Belgium
| | - Monique Elseviers
- Heymans Institute of Pharmacology; Ghent University; Gent Belgium
- Center for Research and Innovation in Care (CRIC); University of Antwerpen; Gent Belgium
| | | | - Sylvie Rottey
- Heymans Institute of Pharmacology; Ghent University; Gent Belgium
- Drug Research Unit Ghent; Ghent University Hospital; Gent Belgium
- Department of Medical Oncology; Ghent University Hospital; Gent Belgium
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12
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Fulone I, Lopes LC. Potentially inappropriate prescriptions for elderly people taking antidepressant: comparative tools. BMC Geriatr 2017; 17:278. [PMID: 29197326 PMCID: PMC5712132 DOI: 10.1186/s12877-017-0674-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 11/23/2017] [Indexed: 12/28/2022] Open
Abstract
Background The use of psychotropic drugs by elderly people is widely spread around the world, given that prevalence of inappropriate medication is frequent. Strictly speaking, in Brazil, the vulnerable population of elderly people is more likely to use Potentially Inappropriate Psychotropic (PIP) due to the impact of social-economic characteristics, to the Brazilian Public Health System, and to the lack of patient monitoring. However, neither the use pattern nor the prevalence rate of PIP have been studied in Brazil so far. The objectives of this study were to determine the prevalence of PIP in elderly outpatients taking antidepressants, and to compare the performance of two different tools (Beers, STOPP). Methods This cross-sectional study involved all the aged outpatients (≥ 60 years of age) taking antidepressants attended by the public health system in a city of the State of São Paulo, Brazil. Data were obtained from a pharmacy database and medical records. All psychotropic drugs evaluated included: antidepressants, antipsychotics, anti-epileptics and benzodiazepines. STOPP and Beers criteria were applied to detect PIP. Results One thousand one hundred forty prescriptions from 174 outpatients were subjected to two different screening tools. The average patient age was 67 (interquartile range 63–74) and the median number of drugs used was 3.0 (interquartile 2–4) per patient. The overall prevalence of PIP was 121 (69.5%). The levels of PIP observed according to tools were 39.6% (STOPP) and 29.9% (Beers).The long-term use of benzodiazepines was the most common PIP recognized, and the one which contributed more significantly to higher levels of PIP than other medications. Conclusions The prevalence of PIP was high among the elderly. STOPP criteria identified more PIP than Beers criteria. Knowledge of PIP prevalence should gear efforts to reduce the level of inappropriate prescriptions and may provide the need for developing national criteria.
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Affiliation(s)
- Izabela Fulone
- Pharmaceutical Sciences Post graduate Course, University of Sorocaba, UNISO, Rodovia Raposo Tavares, KM 92,5, Sorocaba, São Paulo, ZIP Code 18023-000, Brazil
| | - Luciane Cruz Lopes
- Pharmaceutical Sciences Post graduate Course, University of Sorocaba, UNISO, Rodovia Raposo Tavares, KM 92,5, Sorocaba, São Paulo, ZIP Code 18023-000, Brazil.
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