جستجوی مقالات مرتبط با کلیدواژه "pharmacoepidemiology" در نشریات گروه "پزشکی"
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Background
Evaluating a pharmacovigilance system helps identify its deficiencies and could facilitate measures to remedy and improve the quantity and quality of adverse drug reaction (ADR) reports and other opportunities for pharmacovigilance systems strengthening. This study aimed to evaluate the status of pharmacovigilance in Iran using the World Health Organization (WHO) pharmacovigilance indicators with the prospect of identifying the gaps and areas for improvement.
MethodsThis study was conducted in 2 parts. The first part included a secondary analysis of the national data obtained from the Iranian National Pharmacovigilance Center (PVC) using a structured data collection form based on WHO core pharmacovigilance indicators. In the second part, a 3-month prospective study was carried out to investigate 2 outcome indicators, ie, length of stay and costs of medicine-related hospitalization in all patients of 2 main referral hospitals in the southeast and north of Iran.
ResultsIran has a PVC with national policy, trained staff, and a statutory budget. In 2017, the number of ADR reports was 15.0 per 100 000 population, and 262 signals were detected during the preceding 5 years. The average length of stay and costs of medicine-related hospitalization were 5 days and US$817.2 in Afzalipour hospital and 6.6 days and US$306.7 in Razi hospital, respectively. The status of pharmacovigilance in the Iranian public health programs (PHPs) is unknown, and most of the indicators could not be assessed.
ConclusionA robust pharmacovigilance system is a pivotal part of the overall medicines regulatory system. The Iranian pharmacovigilance system has relatively the proper structural condition. Though the underreporting of ADRs, especially medicine-related deaths, is an important issue, and some indicators’ status was unclear. The Iranian pharmacovigilance program requires a higher prioritization, particularly in the PHPs, a greater allocation of resources, and cross-sectoral cooperation to bolster and achieve the pharmacovigilance objectives.
Keywords: Pharmacovigilance, Adverse drug reaction, Pharmacoepidemiology, Iran -
Background
Polypharmacy is a significant patient safety concern.
ObjectivesThis study aims to estimate the prevalence of polypharmacy, its continuity and associated factors, and common medication classes among a large outpatient population in East Azerbaijan province, Iran.
MethodsA retrospective prescription data analysis was performed. The cohort included all ≥ 20 years old subjects with at least one prescription filled during the main three-month study period (2020 March 1 - 2020 May 31). Polypharmacy was defined as being exposed to more than four different medications during the main study period, and continuous polypharmacy was defined as being exposed to more than four medications during both the main study period and follow-up period (2020 October 1 - 2020 December 31). The frequency and prevalence of polypharmacy, along with predictive factors, were estimated. We performed multivariate logistic regression and estimated odds ratios (ORs) to investigate the risk factors for polypharmacy.
Results307,820 patients included (mean age 49.8 years, 62.9% female, mean drug use 3.7 (SD = 2.6). Polypharmacy was observed in 28.3% (CI: 28.1 - 28.4), of which 36.6% experienced continuous polypharmacy. The odds of being exposed to polypharmacy increased with being female, increasing age, and exposure to chronic conditions. The groups of medications most utilized by polypharmacy patients were those indicated for gastro-esophageal reflux diseases, beta-blocking agents, antidepressants, blood glucose-lowering drugs, and antithrombotic agents.
ConclusionsStrategies should be formulated to inform healthcare policymakers and providers about the magnitude of the polypharmacy phenomenon, associated factors, and the common medication classes involved.
Keywords: Polypharmacy, Pharmacoepidemiology, Multimorbidity -
Background
Elderly people are in need of several drugs due to physiological changes and multiple chronic diseases. Studies have shown that anticholinergic drugs can cause cognitive impairment, reduced physical activity, and increased mortality in elderly population. Paying attention to the anticholinergic medication use in older adults can prevent the occurrence of adverse events and increase the quality of health care. This study was conducted to quantify exposure to anticholinergic medicines in older people in Amirkola.
MethodsThis study is a part of the comprehensive cohort project that was being conducted from 2011 on the case patients of 60 years and above that referred to the Amirkola Health Center. A total of 1532 individuals were included, of whom 54.9% were men. The drug information was obtained by observing the patient’s prescription and self-report questionnaires and collected data were analyzed by SPSS software. Exposure to anticholinergic medications was measured using the drug burden index-anticholinergic (DBI-Ach) and the anticholinergic drug scale (ADS).
ResultsAmong the 1532 elderly people with an average age of 69.21 years, 29% had DBI>0 and 36.3% had ADS>0. Also, there was a significant correlation between DBI and ADS (R=0.758). In addition, there is a significant relationship between sex variable with DBI and ADS (P=0.0001). So, women in comparison with men had higher values of DBI and ADS.
ConclusionThe findings of this study indicate that anticholinergic exposure is relatively high especially in older women, which posed special precautions to avoid inappropriate prescribing in the elderly.
Keywords: Anticholinergic Drug Scale, Drug Burden Index, Elderly, Pharmacoepidemiology -
Objective
The purpose of this study was to document the demographic data, to assess the proportion of consumed medicines and the amounts and types of drugs available to households, and to to estimate the probable prevalence of certain diseases in the southern region of Iran.
MethodsIn this cross-sectional population-based study carried out in Shiraz (the central city in the Southern part of Iran), we documented and evaluated the drug usage details in a random sample of 1000 households during 2018–2020. We analyzed the usage of drug categories based on the anatomical therapeutic chemical classification, which the World Health Organization recommends.
FindingsIn the studied population, the average age (± standard deviation) was 45.54 ± 15.82, ranged 18–91 years. More than 90% had medical insurance coverage. About 81.8% of the participants had individual family medicine practitioners, and most of them (93.8%) received medications with a physician’s prescription. The most frequently used medications were cough and cold preparations (12.9%), nervous system drugs (12.6%), and cardiovascular system drugs (11.6%).
ConclusionDespite the easy access to medications for most participants, few individuals (about 6%) received their medications without a prescription. The most frequently prescribed medicines were the common cold, acetaminophen, and metformin. Common cold, gastrointestinal (GI) disorder, and diabetes were the most commonly used medication classes. Furthermore, we have found a probably higher than average prevalence of cardiovascular, GI, and endocrine disorders. This information could be used by the local policymakers as a basis for the estimation and allotment of health-care resources.
Keywords: Medication usage pattern, population‑based study, pharmacoepidemiology -
مقدمهتجویز منطقی دارو از اهم اولویت های پژوهشی و کنترل تجویز سفتریاکسون تزریقی به دلیل عوارض مرگ بار، به عنوان یک چالش مهم در کشور مطرح است. در مطالعه حاضر روند تجویز اشکال تزریقی این دارو به بیماران تامین اجتماعی استان کرمان در سال های 1384 تا 1391 بررسی شده است.روش هادر یک مطالعه مقطعی به صورت داده کاوی توصیفی با استفاده از سامانه جامع دفتر رسیدگی به اسناد پزشکی سازمان تامین اجتماعی کرمان، داده های سه شکل تزریقی داروی سفتریاکسون تجویز شده توسط پزشکان و دندانپزشکان به بیمه شدگان تامین اجتماعی که در فاصله 84/10/1 لغایت 91/3/31 (78 ماه) در داروخانه های استان کرمان ثبت و تحویل شده بودند، به صورت سرشماری استخراج و میزان تجویز دارو بر اساس شاخص Defined Daily Dose با استفاده از آزمون های آماری پارامتریک، آنالیز واریانس یک طرفه و رگرسیون خطی در سطح معنی داری 0/05 مورد تحلیل و مقایسه در گروه های مختلف قرار گرفت.
نتا یج: از حدود 17 میلیون نسخه مربوط به 3621 پزشک و دندانپزشک 28 تا 91 ساله، با نسبت جنسیتی 1/7 مرد به زن، حدود 300 هزار نسخه (1/75 درصد) حاوی سفتریاکسون بودند. متوسط کل نسخ ماهانه، متوسط نسخ ماهانه حاوی دارو و نسبت تجویز در کل نسخ حاوی دارو بین پزشکان عمومی، متخصصین و فوق تخصص ها تفاوت معنی دار آماری داشت (0/001بحث و نتیجه گیریمطالعات تجویز دارو در ایران حاکی از عدم رعایت صحیح الگوهای مصرف و پیروی ناقص از دستورالعمل ها است و نیاز است که مداخلات جدی برای هدایت و کنترل این چالش از سوی نهادهای مسئول صورت گیرد.کلید واژگان: سفتریاکسون, تجویز منطقی دارو, داده کاوی توصیفی, انفورماتیک پزشکی, فارماکواپیدمیولوژیBackgroundRational drug usage is a main priority in health research, and controlling prescribing Ceftriaxone injection due to its fatal adverse effects is a crucial challenge in Iran. The aim of this study was to assess the trend of prescribing Ceftriaxone injections in the medical prescriptions of the Social Security Organization-insured persons in Kerman during 2006- 2012.MethodsIn this Cross-sectional study, using descriptive data mining all data about prescribing the three types of Ceftriaxone injection that were prescribed by the physicians and dentists and dispensed in Kerman pharmacies during 78 months (December 22, 2005 to June 20, 2012), obtained from The Comprehensive Medical Documentation System, in the Medical Documents Audit Office of Social Security Organization in Kerman was extracted by census sampling. Then, the prescribing rate of Ceftriaxone injection (defined daily dose) was analyzed and compared in different groups.ResultsAbout 17 million prescriptions from 3621 physicians and dentists (aged 28-91 years) with male/female ratio as 1.7 were analyzed. About 300 thousands of prescriptions (1.75%) contained Ceftriaxone. The average number of monthly prescriptions; count of monthly prescriptions with the drug; and the ratio of prescribing Ceftriaxone in all prescriptions were significantly different between general practitioners and specialists/sub-specialists (PConclusionThe studies on drug prescribing in Iran show the inappropriate patterns of drug prescribing and use, and also low adherence to the prescribed medications; therefore, serious interventions should be performed by the responsible organizations to control this challenge.Keywords: Ceftriaxone, Rational Drug Usage, Descriptive Data Mining, Medical Informatics, Pharmacoepidemiology -
BackgroundStatins have been effective medications in lowering serum total cholesterol (TC) concentrations across populations over time. The aim of this study was to estimate national and provincial trends in atorvastatin sales in Iran, to systematically quantify its relationship with socio-economic indicators, and changes in TC level.MethodsIn this retrospective ecological study, conducted in Iran, we examined trends in atorvastatin sales, the wealth index (WI) as a validly-available socio-economic indicator, and TC level between 2004 and 2011. The main outcome variable was mean atorvastatin sold in defined daily dose per 100,000 people per day (DPD). We analyzed the relationship between WI and DPD and between DPD and mean TC across time and space.ResultsAt national level, both mean WI and mean DPD showed increasing trend over time, while we observed decreasing trend for TC. Mean WI and DPD in 2011 was nearly 5 and 50 time that of their respective figures in 2004, while the mean TC decreased for nearly 10%. Increases in both WI and DPD had happened in every province, but with different patterns. The maximum and minimum changes in DPD versus WI were seen in Gilan and North Khorasan respectively.ConclusionA striking increase occurred in the sales for atorvastatin in Iran from 2004-2012 in most provinces examined. The wealthier a province became, the more sales were seen for atorvastatin. TC optimistically decreased from 2005 to 2011 and its decrease was positively correlated with increasing sales for atorvastatin.Keywords: Atorvastatin, Socioeconomic status, Hypercholesterolemia, Risk factors, Iran, Epidemiology, Pharmacoepidemiology
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