Dataset Information

Profile, cost and pattern of prescriptions for polymedicated patients in Catalonia, Spain.

ABSTRACT: Polypharmacy is one of the main management issues in public health policies because of its financial impact and the increasing number of people involved. The polymedicated population according to their demographic and therapeutic profile and the cost for the public healthcare system were characterised.Cross-sectional study.Primary healthcare in Barcelona Health Region, Catalonia, Spain (5 105 551 inhabitants registered).All insured polymedicated patients. Polymedicated patients were those with a consumption of ?16 drugs/month.The study variables were related to age, gender and medication intake obtained from the 2008 census and records of prescriptions dispensed in pharmacies and charged to the public health system.There were 36 880 polymedicated patients (women: 64.2%; average age: 74.5±10.9 years). The total number of prescriptions billed in 2008 was 2 266 830 (2 272 920 total package units). The most polymedicated group (up to 40% of the total prescriptions) was patients between 75 and 84 years old. The average number of prescriptions billed monthly per patient was 32±2, with an average cost of €452.7±27.5. The total cost of those prescriptions corresponded to 2% of the drug expenditure in Catalonia. The groups N, C, A, R and M represented 71.4% of the total number of drug package units dispensed to polymedicated patients. Great variability was found between the medication profiles of men and women, and between age groups; greater discrepancies were found in paediatric patients (5-14 years) and the elderly (?65 years).This study provides essential information to take steps towards rational drug use and a structured approach in the polymedicated population in primary healthcare.

SUBMITTER: Lizano-Diez I

PROVIDER: S-EPMC3863130 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Profile, cost and pattern of prescriptions for polymedicated patients in Catalonia, Spain.

Lizano-Díez Irene I Modamio Pilar P López-Calahorra Pilar P Lastra Cecilia F CF Gilabert-Perramon Antoni A Segú Jose L JL Mariño Eduardo L EL

BMJ open 20131212 12

<h4>Objectives</h4>Polypharmacy is one of the main management issues in public health policies because of its financial impact and the increasing number of people involved. The polymedicated population according to their demographic and therapeutic profile and the cost for the public healthcare system were characterised.<h4>Design</h4>Cross-sectional study.<h4>Setting</h4>Primary healthcare in Barcelona Health Region, Catalonia, Spain (5 105 551 inhabitants registered).<h4>Participants</h4>All i ...[more]

PMID: 24334177

Similar Datasets

Project description:There are few studies of careful examination of wildlife casualties in Wildlife Rehabilitation Centers. These studies are essential for detecting menaces to wild species and providing objective criteria about cost-benefit of treatments in those centers. The release rate is considered the main outcome indicator, but other parameters such as length of stay at the center and a cost-benefit index expressed as number of released animals per euro and day, could be used as reliable estimators of the rehabilitation costs.A retrospective study based on 54772 admissions recorded from 1995-2013 in the database of the Wildlife Rehabilitation Center of Torreferrussa (Catalonia, NW Spain) assessed the morbidity, outcomes and cost-benefits of the rehabilitation practices.Three hundred and two species were included: 232 birds (n = 48633), 37 mammals (n = 3293), 20 reptiles (n = 2705) and 13 amphibians (n = 141). The most frequent causes of admission were: 39.8% confiscation of protected species (89.4% passerines), 31.8% orphaned young animals (35.3% swifts, 21.7% diurnal raptors and owls) and 17.4% trauma casualties (46.7% raptors and owls). The highest proportion of releases was found in the captivity confiscation category [87.4% passerines (median time of stay: 12 days)], followed by the orphaned category [78% owls (66 days), 76.5% diurnal birds of prey (43 days), 75.6% hedgehogs (49 days), 52.7% swifts (19 days) and 52% bats (55 days)]. For the trauma group, 46.8% of releases were hedgehogs (44 days) and 25.6% owls (103 days). As regards the cost-benefit index, the trauma casualties and infectious diseases had the worse values with 1.3 and 1.4 released animals/euro/day respectively, and were particularly low in raptors, waders, marine birds and chiroptera. On the contrary, captivity (4.6) and misplacement (4.1) had the best index, particulary in amphibian, reptiles and passerines.Cost-benefit studies including the release rate, the time of stay at the center and the cost-benefit index should be implemented for improving management efficiency of the Wildlife Rehabilitation Centers.

Project description:ObjectivesTo characterise the exposure to valproate within a cohort of pregnant women using electronic health records (EHRs) from Catalonia (System for the Development of Research in Primary Care, SIDIAP).DesignDrug-utilisation cohort study covering the period from January 2011 to June 2020. The study included pregnancy episodes of women from Catalonia identified by the algorithm.SettingData were sourced from SIDIAP, a comprehensive EHR repository that includes information from various data sources: recorded prescriptions (both hospital and primary care), diagnoses and sociodemographic characteristics identified by primary care physicians, and sexual and reproductive health data from ASSIR (used by gynaecologists and midwives).ParticipantsWomen aged 12-50 with at least one pregnancy episode occurred during January 2011-June 2020 and at least a prescription of valproate during pregnancy.Primary and secondary outcomesPrimary outcomes included valproate exposure, measured through prevalence and cumulative incidence in pregnancy episodes and by trimester. The impact of regulatory measures (risk mitigation measures, RMMs) was assessed, and prescriptions over time were analysed using interrupted time series analysis. Secondary outcomes included health issues, pregnancy outcomes, smoking habits and socioeconomic characteristics.ResultsA total of 99 605 pregnancies were identified, with at least 3.03‰ (95% CI 2.69‰ to 3.39‰) exposed to valproate at some point (302 pregnancies, 276 women). The median pregnancy duration was 38.30 weeks (IQR 12.6-40.1), and the median age at pregnancy was 32.37 years (IQR 27.20-36.56). Epilepsy was the most frequent health issue. The prevalence and cumulative incidence of valproate prescriptions decreased during pregnancy and increased postpregnancy. The RMMs implemented in 2014 led to a reduction in monthly valproate prescriptions during pregnancy in this cohort.ConclusionsThe study highlights the decline in valproate prescriptions during pregnancy due to RMMs and underscores the need for standardised methodologies in future studies to ensure the safety of pregnant patients and optimise scientific evidence.

Project description:Burn injuries are one of the leading causes of morbidity worldwide. Although the overall incidence of burns and burn-related mortality is declining, these factors have not been analysed in our population for 25 years. The aim of this study has been to determine whether the epidemiological profile of patients hospitalized for burns has changed over the past 25 years. We performed a retrospective cohort study of patients hospitalised between 1 January 2011 and 31 December 2018 with a primary diagnosis of burns. The incidence of burns in our setting was 3.68/105 population. Most patients admitted for burns were men (61%), aged between 35 and 45 years (16.8%), followed by children aged between 0 and 4 years (12.4%). Scalding was the most prevalent mechanism of injury, and the region most frequently affected was the hands. The mean burned total body surface (TBSA) area was 8.3%, and the proportion of severely burned patients was 9.7%. Obesity was the most prevalent comorbidity (39.5%). The median length of stay was 1.8 days. The most frequent in-hospital complications were sepsis (16.6%), acute kidney injury (7.9%), and cardiovascular complications (5.9%). Risk factors for mortality were advanced age, high abbreviated burn severity index score, smoke inhalation, existing cardiovascular disease full-thickness burn, and high percentage of burned TBSA. Overall mortality was 4.3%. Multi-organ failure was the most frequent cause of death, with an incidence of 49.5%. The population has aged over the 25 years since the previous study, and the number of comorbidities has increased. The incidence and severity of burns, and the percentage of burned TBSA have all decreased, with scalding being the most prevalent mechanism of injury. The clinical presentation and evolution of burns differs between children and adults. Risk factors for mortality were advanced age, smoke inhalation, existing cardiovascular disease, full-thickness burn, and high percentage of burned TBSA.

Project description:Objective: To characterize antimicrobial prescription patterns for dogs in veterinary practices in Spain using the city of Madrid as a model. Design: Retrospective survey. Settings: Dogs attending veterinary practices in the city of Madrid in 2017 were enrolled. Subjects: Three hundred dogs from 30 veterinary practices randomly selected from a set of 388 practices grouped by zip code. The inclusion criterion for dogs was treatment with antibiotics within a few days of the data collection day. Results: For the 300 dogs enrolled, 374 treatments with antimicrobials were recorded, 62.8% (235/374) were veterinary medicinal products and 37.2% (139/374) human medicinal products. The main route of administration was oral (209/374; 55.9%) followed by parenteral (100/374; 26.7%) and topical (65/374; 17.4%). Sixty-five dogs (21.7%) received a perioperative antimicrobial treatment, mainly associated with female obstetrical surgery (19/65; 29%), while 78.3% (235/300) received a pharmaceutical treatment mainly for skin (72/235; 30.6%), respiratory (47/235; 20%), or digestive (41/235; 17.4%) diseases. The most frequently used antimicrobials were beta-lactams for oral (119/209) and parenteral (79/100) administration, especially the combination amoxicillin with clavulanic acid (83/209; oral), amoxicillin alone (42/100; parenteral), and aminoglycosides (32/65) for topical use. Diagnostic confirmation with culture was carried out on only 13 out of 235 dogs receiving therapeutic treatment and nine underwent an antimicrobial susceptibility test. In addition, cytology was performed in 15 dogs. Conclusions: The pattern of antimicrobial prescriptions for dogs in our study was quite similar to that previously described in several European countries, and encompassed the same two highly interconnected key features: major use of amoxicillin with clavulanic acid and a very low level of antimicrobial susceptibility testing before prescription. Consequently, we recommend that the measures for rationalizing antimicrobial prescription for dogs in Spain should follow those implemented in other countries, especially confirming the diagnosis and promoting the use of hygiene measures by owners.

Dataset Information

Profile, cost and pattern of prescriptions for polymedicated patients in Catalonia, Spain.

Publications

Profile, cost and pattern of prescriptions for polymedicated patients in Catalonia, Spain.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets