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TRENDS IN THE OUTPATIENT UTILIZATION OF ANTIPSYCHOTIC DRUGS IN THE CITY OF ZAGREB IN THE TEN-YEAR PERIOD AS A TOOL TO ASSESS DRUG PRESCRIBING RATIONALITY

Marina Polić-Vižintin ; Dr Andrija Štampar Institute of Public Health, Zagreb, Croatia
Ingrid Tripković ; Public Health Institute of Split-Dalmatia County, Split, Croatia
Danijela Štimac ; Dr Andrija Štampar Institute of Public Health, Zagreb, Croatia; Department of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
Zvonimir Šostar ; Dr Andrija Štampar Institute of Public Health, Zagreb, Croatia
Mirjana Orban ; Dr Andrija Štampar Institute of Public Health, Zagreb, Croatia


Puni tekst: engleski pdf 267 Kb

str. 415-419

preuzimanja: 384

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Sažetak

Background: The aim was to determine distribution and trends in the outpatient utilization of antipsychotics to evaluate the
rationality of antipsychotic drug prescribing during the ten year period.
Subjects and methods: The epidemiological method of descriptive and analytical observation was used. Data on drug utilization
from Zagreb Municipal Pharmacy were used to calculate the number of defined daily doses (DDD) and DDD per 1000 inhabitants
per day (DDD/TID) using the World Health Organization Anatomical-Therapeutic-Chemical methodology. The ratio of typical
versus atypical antipsychotics served as an indicator on assessing the rationality of the utilization. Data on the use of
anticholinergics in the treatment of neuroleptic side effects were also included.
Results: Outpatient utilization of antipsychotics showed a declining pattern from 14.17 in 2001 to 8.42 DDD/TID in 2010. The
utilization of atypical antipsychotics increased by 60% (from 3.68 to 5.89 DDD/TID), while the utilization of typical antipsychotics
decreased by 76% (from 10.49 to 2.53 DDD/TID). The drugs showing the largest increase were olanzapine (from 1.21 to 2.78
DDD/TID) and quetiapine (from 0 to 0.68 DDD/TID). The typical/atypical antipsychotic ratio changed from 1:0.4 in 2001 to 1:2.3 in
2010. A 2.3-fold decrease was recorded in the utilization of anticholinergics (from 2.05 to 0.91 DDD/TID).
Conclusions: Total consumption of neuroleptics significantly decreased. A decrease was also recorded in the utilization of
anticholinergics. Study results pointed to two favorable features, i.e. low use of typical antipsychotics and the ratio of typical and
atypical antipsychotics. Implementation of the new clinical guidelines for nervous system disorders and updating of the list of
reimbursable drugs with the addition of new ones contributed to the observed improvement in the prescribing patterns during the
study period. Using the WHO ATC/DDD methodology and rationality indicators in the assessment of trends in the outpatient
utilization of psychopharmaceuticals over a ten-year period proved efficient in the evaluation of prescribing rationality.

Ključne riječi

antipsychotic drugs; utilization; anticholinergics; Zagreb; ATC/DDD methodology

Hrčak ID:

177176

URI

https://hrcak.srce.hr/177176

Datum izdavanja:

12.12.2016.

Posjeta: 728 *