Ferdinando E Vegni1, Paul Wilkinson. 1. Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK. ferdinando.vegni@lshtm.ac.uk
Abstract
OBJECTIVE: To examine the patterns of respiratory drugs use in the Lombardy region of Italy, and to quantify the period prevalence of different drug-dose combinations defined by reference to international guidelines for prescription in asthma and chronic obstructive pulmonary disease. DESIGN: Analysis of records from an anonymised population-based database of dispensed prescriptions. SETTING: Lombardy, 1995-1997. METHODS: Analyses were made of prescription records of patients who had at least one respiratory drug dispensed during the study period. Prescriptions for the same individual were linked using a unique identifier. MAIN OUTCOMES: Number of patients using respiratory drugs; number of visits to the pharmacy; defined daily doses. MAIN RESULTS: 1,387,004 or 15.5% of the resident Lombardy population had at least one dispensed prescription of a respiratory drug in the three years of study. The annual percentage increased from 6.6% in 1995 to 7.9% in 1997. 808,786 patients (58.3% of respiratory drug users) had only one visit to the pharmacy during this period, while the 25.1% of respiratory drug-user (3.9% of the resident population) who had three or more visits to the pharmacy in three years, accounted for 86.1% of all respiratory drug use in terms of defined daily doses. When combinations of prescribed drugs were examined in the light of published guidelines, we estimated that <2.8%> of the population had patterns of drug prescription appropriate for mild intermittent or persistent forms of asthma/chronic obstructive pulmonary disease, and <1.1%> had prescription patterns appropriate for moderate or severe disease. CONCLUSIONS: The definition of specific drug use patterns by individual can provide prevalence measures that are broad proxies for varying categories of respiratory disease. However, a very high proportion of people who receive respiratory drugs do so for one-off or very infrequent episodes of illness. Analysis of the infrequent and more regular users of respiratory drugs may be useful for comparative research.
OBJECTIVE: To examine the patterns of respiratory drugs use in the Lombardy region of Italy, and to quantify the period prevalence of different drug-dose combinations defined by reference to international guidelines for prescription in asthma and chronic obstructive pulmonary disease. DESIGN: Analysis of records from an anonymised population-based database of dispensed prescriptions. SETTING: Lombardy, 1995-1997. METHODS: Analyses were made of prescription records of patients who had at least one respiratory drug dispensed during the study period. Prescriptions for the same individual were linked using a unique identifier. MAIN OUTCOMES: Number of patients using respiratory drugs; number of visits to the pharmacy; defined daily doses. MAIN RESULTS: 1,387,004 or 15.5% of the resident Lombardy population had at least one dispensed prescription of a respiratory drug in the three years of study. The annual percentage increased from 6.6% in 1995 to 7.9% in 1997. 808,786 patients (58.3% of respiratory drug users) had only one visit to the pharmacy during this period, while the 25.1% of respiratory drug-user (3.9% of the resident population) who had three or more visits to the pharmacy in three years, accounted for 86.1% of all respiratory drug use in terms of defined daily doses. When combinations of prescribed drugs were examined in the light of published guidelines, we estimated that <2.8%> of the population had patterns of drug prescription appropriate for mild intermittent or persistent forms of asthma/chronic obstructive pulmonary disease, and <1.1%> had prescription patterns appropriate for moderate or severe disease. CONCLUSIONS: The definition of specific drug use patterns by individual can provide prevalence measures that are broad proxies for varying categories of respiratory disease. However, a very high proportion of people who receive respiratory drugs do so for one-off or very infrequent episodes of illness. Analysis of the infrequent and more regular users of respiratory drugs may be useful for comparative research.
Authors: N Agabiti; S Mallone; F Forastiere; G M Corbo; S Ferro; E Renzoni; P Sestini; F Rusconi; G Ciccone; G Viegi; E Chellini; S Piffer Journal: Epidemiology Date: 1999-11 Impact factor: 4.822
Authors: C Campello; M Ferrari; A Poli; M Olivieri; S Tardivo; G Verlato; C Martini; C Biasin; G Lampronti; B Cenci; V Lo Cascio Journal: Monaldi Arch Chest Dis Date: 1998-10