Trend primene lekova u bolnici za fizikalnu medicinu i rehabilitaciju

  • Gordana M. Ljubojević Institute of Physical Medicine and Rehabilitation “Dr Miroslav Zotović” Banja Luka, Hospital Pharmacy Department, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Milan Mastikosa Institute of Physical Medicine and Rehabilitation “Dr Miroslav Zotović” Banja Luka, Hospital Pharmacy Department, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Tanja Dostanić Došenović Institute of Physical Medicine and Rehabilitation “Dr Miroslav Zotović” Banja Luka, Hospital Pharmacy Department, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Snježana Novaković Bursać Institute of Physical Medicine and Rehabilitation “Dr Miroslav Zotović” Banja Luka, Department of Physical Rehabilitation, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Nataša Tomić Institute of Physical Medicine and Rehabilitation “Dr Miroslav Zotović” Banja Luka, Department of Physical Rehabilitation, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Goran Talić Institute of Physical Medicine and Rehabilitation “Dr Miroslav Zotović” Banja Luka, Department of Orthopaedic Surgery, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Ranko Škrbić University of Banja Luka, Faculty of Medicine, Department of Basic & Clinical Pharmacology, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
  • Miloš P. Stojiljković University of Banja Luka, Faculty of Medicine, Department of Basic & Clinical Pharmacology, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
DOI: https://doi.org/10.2298/VSP180118046L
Ključne reči: bolnice, medicina, fizikalna, lečenje lekovima, lekovi, korišćenje

Sažetak


Apstrakt

 

Uvod/Cilj. Praćenjem potrošnje lekova mogu se identifikovati farmakoterapijski problemi i unaprediti racionalna primena lekova, te je cilj ovog istraživanja bio da se utvrdi i analizira potrošnja lekova u bolnici za fizikalnu medicinu i rehabilitaciju tokom perioda 2011–2016. godine. Metode. Potrošnja lekova praćena je i analizirana pomoću ATC/DDD metodologije (anatomsko-terapijsko-hemijska klasifikacija/definisane dnevne doze) i izražena kao broj DDD/100 bolničkih dana. Korišćene su vrednosti DDD prema Svetskoj zdravstvenoj organizaciji. Trend potrošnje lekova analiziran je putem parametra Com­pound Aggregate Growth Rate (CAGR) koji se definiše kao prosečna godišnja stopa promene neke vrednosti u periodu posmatranja. Rezultati. Broj bolničkih dana rastao je tokom šesto­go­dišnjeg perioda (CAGR 1,8% godišnje). Ukupan broj DDD lekova izdatih na odeljenja i broj DDD/100 bolničkih dana pokazali su pad (CAGR -2,0% i -3,7%, respektivno). Dnev­na potrošnja lekova je finansijski varirala od 1,38 KM u 2013. do 0,95 KM u 2016. godini, sa CAGR -1,8%. Najviše su korišćeni lekovi iz ATC grupa C, A, B, M i N koji su zajedno činili u proseku 77% godišnje potrošnje lekova to­kom posmatranog perioda. Naj­zastupljeniji lekovi po po­tro­šnji bili su hidroksikobalamin, alfa-lipoinska kise­lina, ena­lap­ril, diklofenak, amlodipin, acetisalicilna kiselina, pantoprazol, paracetamol i bromazepam. Zaključak. Potrošnja lekova u našoj ustanovi bila je skromna i gotovo bez promena 2016. godine u odnosu na 2011. godinu. Osim pro­minentne po­trošnje vitamina B12 i alfa-lipoinske kise­line, usta­novljena su i neka odstupanja od racionalnog pro­pisivanja le­kova po­put prekomerne upotrebe diklo­fenaka u odnosu na ibu­profen, te značajna potrošnja inhibitora pro­tonske pumpe. Potrebne su ciljane i kontinuirane edukacije radi unapre­đenja prakse propisivanja lekova.

Reference

REFERENCES

Strom BL. Pharmacoepidemiology. 4th ed. Chichester, UK: John Wiley and Sons; 2006.

World Health Organization. Introduction to Drug Utilization Research. Oslo. 2003. Available from: http://apps.who.int/medicinedocs/pdf/s4876e/s4876e.pdf. [accessed 2017 March 27].

Zuppa A, Vijayakumar S, Jayaraman B, Patel D, Narayan M, Vi-jayakumar K, et al. An informatics approach to assess pediatric pharmacotherapy: design and implementation of a hospital drug utilization system. J Clin Pharmacol 2007; 47(9): 1172–80.

Wettermark B, Elseviers M, Almarsdóttir AB, Andersen M, Benko R, Bennie M, et al. Introduction to drug utilization re-search. In: Elseviers M, Wettermark B, Almarsdottir AB, An-dersen M, Benko R, Bennie M, et al, editors. Drug Utilization Research: Methods and Applications. Chichester: John Wiley & Sons; 2016. p. 1–12.

Jhaveri BN, Patel TK, Barvaliya MJ, Tripathi CB. Drug utilization pattern and pharmacoeconomic analysis in geriatric medical in-patients of a tertiary care hospital of India. J Pharmacol Pharmacother 2014; 5(1): 15–20.

Chatterjee S, Mandal A, Lyle N, Mukherjee S, Singh AK. Drug utilization study in a neonatology unit of a tertiary care hospital in eastern India. Pharmacoepidemiol Drug Saf 2007; 16(10): 1141–5.

Sequi M, Campi R, Clavenna A, Bonati M. Methods in pharma-coepidemiology: a review of statistical analyses and data re-porting in pediatric drug utilization studies. Eur J Clin Phar-macol 2013; 69(3): 599–604.

Janković S, Đukić-Dejanović S. Drug utilization trends in Clinical hospital centre 'Kragujevac' from 1997-1999. Ind J Pharmacol 200; 33: 29–36.

Marković-Peković V, Škrbić R. Long-term drug use and poly-pharmacy among the elderly population in the Republic of Srpska, Bosnia and Herzegovina. Vojnosanit Pregl 2016; 73(5): 435–41.

Marković-Peković V, Škrbić R, Petrović A, Vlahović-Palčevski V, Mrak J, Bennie M, et al. Polypharmacy among the elderly in the Republic of Srpska: extent and implications for the future. Expert Rev Pharmacoecon Outcomes Res 2016; 16(5): 609–18.

Marković-Peković V, Škrbić R, Godman B, Gustafsson LL. Ongo-ing initiatives in the Republic of Srpska to enhance prescribing efficiency: influence and future directions. Expert Rev Phar-macoecon Outcomes Res 2012; 12(5): 661–71.

Marković-Peković V, Stoisavljević-Šatara S, Škrbić R. Outpatient utilization of drugs acting on nervous system: a study from the Republic of Srpska, Bosnia & Herzegovina. Eur J Clin Phar-macol 2010; 66(2): 177–86.

Marković-Peković V, Stoisavljević-Šatara S, Škrbić R. Utilisation of cardiovascular medicines in Republic of Srpska, Bosnia and Herzegovina, 5 years study. Pharmacoepidemiol Drug Saf 2009; 18(4): 320–6.

WHO Collaborating Centre for Drug Statistics Methodology. Guide-lines for ATC classification and DDD assignment 2017. Oslo; 2016. 20th ed. Available from: https://www.whocc.no/ fi-learchive/publications/2017_guidelines_web.pdf. [accessed 2017 March 28].

Škrbić R, Babić-Đurić D, Stoisavljević-Šatara S, Stojaković N, Nežić L. The role of drug donations on hospital use of antibiotics during the war and postwar period. Int J Risk Safety Med 2001; 14(1–2): 31–40.

Compound Aggregate Growth Rate - CAGR. Available from: http://www.investopedia.com /terms/c/cagr.asp [accessed 2017 July 27].

Rajarathna K, Vishwanath M, Ramaswamy AD, Kamath SD, Sukritha S, Hosthota A, et al. Evaluation of WHO prescribing indicators among orthopaedic inpatients at tertiary care hospital. J Chem Pharm Res 2014; 6(8): 278–80.

Godman B, Wettermark B, van Woerkom M, Fraeyman J, Alvarez-Madrazo S, Berg C, et al. Multiple policies to enhance prescrib-ing efficiency for established medicines in Europe with a par-ticular focus on demand-side measures: findings and future implications. Front Pharmacol 2014; 5: 106.

Goldberg H, Mibielli MA, Nunes CP, Goldberg SW, Buchman L, Mezitis SG,et al. A double-blind, randomized, comparative study of the use of a combination of uridine triphosphate tri-sodium, cytidine monophosphate disodium, and hydroxocoba-lamin, versus isolated treatment with hydroxocobalamin, in patients presenting with compressive neuralgias. J Pain Res 2017; 10: 397–404.

Smelt HJM, Pouwels S, Smulders JF. Different Supplementation Regimes to Treat Perioperative Vitamin B12 Deficiencies in Bariatric Surgery: a Systematic Review. Obes Surg 2017; 27(1): 254–62.

Brayfield A. Hydroxocobalamin. In: Brayfield A, edi-tor.Martindale: The Complete Drug Reference. 8th ed. Lon-don, UK: PhP, Pharmaceutical Press, 2014.

Kennedy DO. B Vitamins and the Brain: Mechanisms, Dose and Efficacy-A Review. Nutrients 2016; 8(2): 68.

Mauro GL, Martorana U, Cataldo P, Brancato G, Letizia G. Vita-min B12 in low back pain: a randomised, double-blind, place-bo-controlled study. Eur Rev Med Pharmacol Sci 2000; 4(3): 53–8.

Chiu CK, Low TH, Tey YS, Singh VA, Shong HK. The efficacy and safety of intramuscular injections of methylcobalamin in patients with chronic nonspecific low back pain: a randomised controlled trial. Singapore Med J 2011; 52(12): 868–73.

Garcia-Alcala H, Santos Vichido CI, Islas Macedo S, Genestier-Tamborero CN,Minutti-Palacios M, Hirales Tamez O, et al. Treat-ment with α-Lipoic Acid over 16 Weeks in Type 2 Diabetic Patients with Symptomatic Polyneuropathy Who Responded to Initial 4-Week High-Dose Loading. J Diabetes Res 2015; 2015: 189857.

Ziegler D, Low PA, Freeman R, Tritschler H, Vinik AI. Predictors of improvement and progression of diabetic polyneuropathy following treatment with α-lipoic acid for 4years in the NATHAN 1 trial. J Diabetes Complications 2016; 30(2): 350–6.

Lei H, Gao Q, Liu S, Xu J. The Benefit and Safety of Aspirin for Primary Prevention of Ischemic Stroke: A Meta-Analysis of Randomized Trials. Front Pharmacol 2016; 7: 440.

Elwood PC, Morgan G, Galante J, Chia JWK, Dolwani S, Graziano JM, Steward W. Systematic Review and Meta-Analysis of Randomised Trials to Ascertain Fatal Gastrointes-tinal Bleeding Events Attributable to Preventive Low-Dose Aspirin: No Evidence of Increased Risk. PLoS One 2016; 11(11): e0166166.

Lanza FL, Chan FKL, Quigley EM. Guidelines for Prevention of NSAID-Related Ulcer Complications. Am J Gastroenterol 2009; 104(3): 728–38.

Manohar V, Vinay M, Jayasree T, Kishan P, Ubedulla S, Dixit R. Prescribing pattern of gastroprotective agents with non-steroidal anti-inflammatory drugs. J Pharmacol Pharmacother 2013; 4(1): 59–60.

Eusebi LH, Rabitti S, Artesiani ML, Gelli D, Montagnani M, Zagari RM, et a. Proton pump inhibitors: Risks of long-term use. J Gastroenterol Hepatol 2017; 32(7): 1295–302.

Krum H, Swergold G, Gammaitoni A, Peloso PM, Smugar SS, Curtis SP, et al. Blood Pressure and Cardiovascular Outcomes in Patients Taking Nonsteroidal Antiinflammatory Drugs. Cardiovasc Ther 2011; 30(6): 342–50.

European Medicine Agency. New safety advice for diclofenac. EMA. 2013. Available from: http:

//www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Diclofenac-containing medicin-al_products/European_Commission_final_decision/WC500155819.pdf. [accessed 2017 August 31].

Cosano G, Giangreco M, Ussai S, Giorgini T, Biasutti E, Barbone F, et al. Polypharmacy and the use of medications in inpatients with acquired brain injury during post-acute rehabilitation: A cross-sectional study. Brain Inj 2016; 30(3): 353–62.

Binder A, Baron R. The Pharmacological Therapy of Chronic Neuropathic Pain. Dtsch Arztebl Int 2016; 113(37): 616–25.

Lima M, Farage L, Cury M, Bahamad F. Update on Middle Ear Barotrauma after Hyperbaric Oxygen Therapy – Insights on Pathophysiology. Int Arch Otorhinolaryngol 2014; 18(2): 204–9.

Yamamoto Y, Noguchi Y, Enomoto M, Yagishita K, Kitamura K. Otological complications associated with hyperbaric oxygen therapy. Eur Arch Otorhinolaryngol 2016; 273(9): 2487–93.

Capes JP, Tomaszewski C. Prophylaxis against middle ear baro-trauma in US hyperbaric oxygen therapy centers. Am J Emerg Med 1996; 14(7): 645–8.

Müller-Pebody B, Muscat M, Pelle B, Klein BM, Brandt CT, Monnet DL. Increase and change in pattern of hospital antimicrobial use, Denmark, 1997–2001. J Antimicrob Chemother 2004; 54(6): 1122–6.

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Objavljeno
2021/07/06
Broj časopisa
Vol. 76 Br. 12 (2019): Vojnosanit Pregl
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