Systemic antibiotics and asthma medicines dispensed to 0-12 year olds significantly decreased during the COVID-19 pandemic in 2020.
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ABSTRACT: Aim
Nationwide lockdowns and social restrictions during the COVID-19 pandemic have reduced childhood infections. We assessed how many items of systemic antibiotics and asthma medicines were dispensed to children aged 0-12 years in Finland before and during the pandemic and analysed the reimbursement costs.Methods
The data came from the national Finnish register of reimbursable prescriptions, which is maintained by the country's Social Insurance Institution. It included all prescriptions for antibiotics and asthma medicines dispensed to children aged 0-12 years in 2019 and 2020. Prescription rates per 1000 children were calculated for each quarter and compared using rate ratios and 95% confidence intervals (95% CI).Results
Overall dispensing for antibiotics decreased by 55.3% and was most prominent for macrolides for children aged 0-5 years (59.6%, 95% CI 60.9%-58.2%). Asthma medicines decreased by 19.8%, and the most prominent reduction was in short-acting beta-agonists for children aged 0-5 years (35.2%, 95% CI 36.1%-34.2%). These reduced reimbursement costs by 3.4 million Euros from 2019 to 2020.Conclusion
This nationwide study showed that the number of antibiotics and asthma medicines decreased by 59.6% and 19.8% respectively from 2019 to 2020, generating a cost saving of 3.4 million Euros.
SUBMITTER: Haapanen M
PROVIDER: S-EPMC8652669 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveThe purpose of this study was to evaluate a collaborative community-based program that aims to a) increase the health, safety and talent development of youth, and b) contribute to the reduction of socioeconomic inequalities.MethodsA difference-in difference design with two separate cross-sectional samples in 2018 (n = 984) and 2021 (n = 413) among 0- to 12-year-olds with an intervention and comparator condition was used. The program, called Promising Neighbourhoods, consists of collaboration with community stakeholders, data-based priority setting, knowledge-and theory-based policies, and evidence-based interventions. The program was implemented in three neighbourhoods which were compared with three similar comparator neighbourhoods in which the program was not implemented. Logistic difference-in-difference regression was used to test effectiveness of the intervention on informal parenting support, outdoor-play, sport club membership, general health and risk of emotional and behavioural difficulties and to examine differences in intervention effects between children with a lower or higher socioeconomic status.ResultsA significant intervention effect of the Promising Neighbourhoods program after two-years was found for outdoor-play (OR 0.61; 95%CI 0.37, 0.99). No other significant intervention effects were found for other outcomes. No different interventions effects were found for children with a lower or higher socioeconomic status on outcomes.ConclusionThe findings of this study indicate a positive intervention effect for one of the outcomes in 0- to 12-year-olds. Further mixed-methods evaluation research and using longer follow-up periods are needed to examine the value of these type of programs. Further development of Promising Neighbourhoods seems warranted.Trial registrationThis study was prospectively registered in the Netherlands National Trial Register (Number: NL7279) on 26 September 2018.
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Project description:AIM:This study explored the prevalence of atopic and nonatopic asthma in 12-year-old children and whether they were associated with different risk factors. In particular, we wanted to analyse whether receiving antibiotics during the first week of life was associated with asthma at that age. METHODS:Data were obtained from a longitudinal cohort study of 5654 Swedish children born in 2003. The parents answered questionnaires from the age of six months until 12 years. The response rate at 12 years was 3637/4777 (76%). RESULTS:At 12 years, 6.4% reported current doctor-diagnosed asthma. Treatment with antibiotics during the first week of life was associated with an increased risk of atopic asthma, with an adjusted odds ratio of 2.2 and 95% confidence interval of 1.2-4.2. Being born small for gestational age was associated with an increased risk of nonatopic asthma, with an adjusted odds ratio of 3.8 and 95% confidence interval of 1.1-13.7. Asthma that only occurred with colds was reported by 28%. CONCLUSION:Antibiotic treatment during the first week of life was associated with an increased risk of atopic asthma at 12 years, suggesting an immune-mediated effect. Being born small for gestational age increased the risk of nonatopic asthma.
| S-EPMC6175332 | biostudies-literature
Project description:BackgroundPatients' knowledge about their prescribed medicines is one of the most important antecedents of successful therapy. Poor knowledge about medicines can lead to serious consequences such as non-adherence and misunderstanding of the significance of adverse events. The objective of this study is to understand the factors that are responsible for a patients' lack of knowledge regarding their medicines, by taking the perspective of the patient as well as that of healthcare professionals. Much of the work in this area has been undertaken in the setting of developed or semi-developed countries, and there is a scarcity of information from developing nations such as Pakistan.MethodsThis was a large qualitative study set in the hospital outpatient environment in a teaching hospital in the Punjab province of Pakistan. Data were collected from dialogue with patients (n = 19) and healthcare providers (n = 16) i.e., doctors and dispensers (where a dispenser is a person who merely dispenses medicines; i.e. is not a pharmacist) through in-depth semi-structured interviews. Patients having limited knowledge about their dispensed medicines were assessed using a checklist. The healthcare providers were recruited through a convenience sampling strategy, based on their availability and willingness to participate in the study. Based on the objectives of the study, a pilot tested interview protocol was developed, and used to conduct the interviews. The sample size was controlled by using saturation point criteria. All interviews were audio recorded and transcribed verbatim. The data were analyzed to draw conclusions using inductive thematic content analysis.ResultsThe analysis of data yielded 31 categories (patients = 19, healthcare professionals = 12), 10 subthemes and three themes. The major themes were healthcare professional-related factors, patient-related factors and system-related factors. The health professional related subthemes included: behaviour and attitude and professional liabilities and liaison. The patient related subthemes included: eagerness of the patients and lack of understanding and misconception. The system-related factors included: patients with special needs, perceived role of the pharmacist, prescription and medicines, and staff workload.ConclusionHealthcare professional related, patient related and system related factors have a significant influence on patients' knowledge about dispensed medicines. The non-professional behaviour of doctors, increased staff workload, inadequate time and attention provided by healthcare professionals to patients, illiteracy of patients, lack of specialized labelling on medicines for illiterate patients and absence of pharmacists at the hospital, were the major concerns identified in this study. The study points to a need for appropriate patient education and counselling with regards medicines, improved coordination between hospital staff, and provision of some basic system-related facilities which are pivotal for enhancing patients' knowledge and adherence to their treatment regimens.
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Project description: Not available
| S-EPMC6513273 | biostudies-literature
Project description:Rationale: Damage to airway epithelium is followed by deposition of extracellular matrix (ECM) and migration of adjacent epithelial cells. We have shown that epithelial cells from asthmatic children fail to heal a wound in vitro. Objectives: To determine whether dysregulated ECM production by the epithelium plays a role in aberrant repair in asthma. Methods: Airway epithelial cells (AEC) from children with asthma (n=36), healthy atopic (n=23) and healthy non-atopic controls (n=53) were investigated by microarray, gene expression and silencing, transcript regulation analysis and ability to close mechanical wounds. Results: Wound repair of AEC from healthy and atopic children were not significantly different and were both faster than AEC from asthmatics. Microarray analysis revealed differential expression of multiple gene sets associated with repair and remodeling in asthmatic AEC. Fibronectin (FN) was the only ECM component whose expression was significantly lower in asthmatic AEC. Expression differences were verified by qPCR and ELISA, and reduced FN expression persisted in asthmatic cells over passage. Silencing of FN expression in non-asthmatic AEC inhibited wound repair, while addition of FN to asthmatic AEC restored reparative capacity. Asthmatic AEC failed to synthesize FN in response to wounding or cytokine/growth factor stimulation. Exposure to 5â, 2âdeoxyazacytidine had no effect on FN expression and subsequent analysis of the FN promoter did not show evidence of DNA methylation. Conclusions: These data show that the reduced capacity of asthmatic epithelial cells to secrete FN is an important contributor to the dysregulated AEC repair observed in these cells. 16 arrays, 2 experimental groups, asthma atopic, AA, and healthy non-atopic, HN.
2010-04-12 | E-GEOD-18965 | biostudies-arrayexpress
Project description:OBJECTIVE:To investigate community pharmacists' knowledge, attitudes, perceptions and habits with regard to antibiotic dispensing without medical prescription in Spain. METHODS:A qualitative research using focus group method (FG) in Galicia (north-west Spain). FG sessions were conducted in the presence of a moderator. A topic script was developed to lead the discussions, which were audiorecorded to facilitate data interpretation and transcription. Proceedings were transcribed by an independent researcher and interpreted by two researchers working independently. We used the Grounded Theory approach. SETTING:Community pharmacies in Galicia, region Norwest of Spain. PARTICIPANTS:Thirty pharmacists agreed to participate in the study, and a total of five FG sessions were conducted with 2-11 pharmacists. We sought to ensure a high degree of heterogeneity in the composition of the groups to improve our study's external validity. Pharmacists' participation had no gender or age restrictions, and an effort was made to form FGs with pharmacists who were both owners and non-owners, provided in all cases that they were Official Colleges of Pharmacists-registered community pharmacists. For the purpose of conducting FG discussions, the basic methodological principle of allowing groups to attain their 'own structural identity' was applied. MAIN OUTCOME MEASUREMENTS:Community pharmacists' habits and knowledge with regard to antibiotics and identification of the attitudes and/or factors that influence antibiotic dispensing without medical prescription. RESULTS:Pharmacists attributed the problem of antibiotics dispensed without medical prescription and its relationship to antibiotic resistance to the following attitudes: external responsibility (doctors, dentists and the National Health Service (NHS)); acquiescence; indifference and lack of continuing education. CONCLUSIONS:Despite being a problem, antibiotic dispensing without a medical prescription is still a common practice in community pharmacies in Galicia, Spain. This practice is attributed to acquiescence, indifference and lack of continuing education. The problem of resistance was ascribed to external responsibility, including that of patients, physicians, dentists and the NHS.
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Project description:Documenting the indication on prescriptions and dispensed medicines labels is not standard practice in Australia. However, previous studies that have focused on the content and design of dispensed medicines labels, have suggested including the indication as a safety measure. The aim of this study was to investigate the perspectives of Australian consumers, pharmacists and prescribers on documenting the indication on prescriptions and dispensed medicines labels.Semi-structured interviews were conducted and mock-up of dispensed medicines labels were designed for participants. Consumers (n?=?19) and pharmacists (n?=?7) were recruited by convenience sample at community pharmacies in Sydney (Australia) and prescribers (n?=?8), including two medical students, were recruited through snowballing.Thirty-four participants were interviewed. Most participants agreed that documenting the indication would be beneficial especially for patients who are forgetful or take multiple medications. Participants also believed it would improve consumers' medication understanding and adherence. Prescribers and pharmacists believed it could help reduce prescribing and dispensing errors by matching the drug/dosage to the correct indication. Prescribers refrained from documenting the indication to protect patients' privacy; however, most patients did not consider documenting the indication as a breach of privacy. Prescribers raised concerns about the extra time to include indications on prescriptions and best language to document indications, using plain language as opposed to medical terminology.All interviewed stakeholders identified numerous benefits of documenting the indication on prescriptions and dispensed medicines labels. Whether these potential benefits can be realized remains unknown and addressing prescribers' concern regarding the time involved in documenting the indication on prescriptions remains a challenge for vendors of electronic medication management systems.
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Project description:Rationale: Damage to airway epithelium is followed by deposition of extracellular matrix (ECM) and migration of adjacent epithelial cells. We have shown that epithelial cells from asthmatic children fail to heal a wound in vitro. Objectives: To determine whether dysregulated ECM production by the epithelium plays a role in aberrant repair in asthma. Methods: Airway epithelial cells (AEC) from children with asthma (n=36), healthy atopic (n=23) and healthy non-atopic controls (n=53) were investigated by microarray, gene expression and silencing, transcript regulation analysis and ability to close mechanical wounds. Results: Wound repair of AEC from healthy and atopic children were not significantly different and were both faster than AEC from asthmatics. Microarray analysis revealed differential expression of multiple gene sets associated with repair and remodeling in asthmatic AEC. Fibronectin (FN) was the only ECM component whose expression was significantly lower in asthmatic AEC. Expression differences were verified by qPCR and ELISA, and reduced FN expression persisted in asthmatic cells over passage. Silencing of FN expression in non-asthmatic AEC inhibited wound repair, while addition of FN to asthmatic AEC restored reparative capacity. Asthmatic AEC failed to synthesize FN in response to wounding or cytokine/growth factor stimulation. Exposure to 5’, 2’deoxyazacytidine had no effect on FN expression and subsequent analysis of the FN promoter did not show evidence of DNA methylation. Conclusions: These data show that the reduced capacity of asthmatic epithelial cells to secrete FN is an important contributor to the dysregulated AEC repair observed in these cells.
2010-03-31 | GSE18965 | GEO
Project description:PurposeResearchers have previously shown that individual differences in measures of receptive language ability at age 12 are highly heritable. In the current study, the authors attempted to identify some of the genes responsible for the heritability of receptive language ability using a genome-wide association approach.MethodThe authors administered 4 Internet-based measures of receptive language (vocabulary, semantics, syntax, and pragmatics) to a sample of 2,329 twelve-year-olds for whom DNA and genome-wide genotyping were available. Nearly 700,000 single-nucleotide polymorphisms (SNPs) and 1 million imputed SNPs were included in a genome-wide association analysis of receptive language composite scores.ResultsNo SNP associations met the demanding criterion of genome-wide significance that corrects for multiple testing across the genome ( p < 5 × 10 -8). The strongest SNP association did not replicate in an additional sample of 2,639 twelve-year-olds.ConclusionsThese results indicate that individual differences in receptive language ability in the general population do not reflect common genetic variants that account for more than 3% of the phenotypic variance. The search for genetic variants associated with language skill will require larger samples and additional methods to identify and functionally characterize the full spectrum of risk variants.
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Project description:IntroductionAntimicrobial resistance (AMR) is an emerging global threat. It increases mortality and morbidity and strains healthcare systems. Health care professionals can counter the rising AMR by promoting antibiotic stewardship and facilitating new drug development. Even with the economic and scientific challenges, it is reassuring that new agents continue to be developed.MethodsThis review addresses new antibiotics in the pipeline. We conducted a review of the literature including Medline, Clinicaltrials.org, and relevant pharmaceutical companies for approved and in pipeline antibiotics in phase 3 or new drug application (NDA).ResultsWe found a number of new antibiotics and reviewed their current development status, mode of action, spectra of activity, and indications for which they have been approved. The included studies from phase 3 clinical trials were mainly utilized for the treatment of acute bacterial skin and skin structure infections, community-acquired bacterial pneumonia, and pneumonia acquired in the healthcare settings. The number of these agents is limited against high priority organisms. The identified antibiotics were based mainly on previously known molecules or pre-existing antimicrobial agents.ConclusionThere are a limited number of antibiotics against high priority organisms such as multi-drug-resistant Pseudomonas aeruginosa, and carbapenem-resistant Enterobacteriaceae. New antimicrobial agents directed against the top priority organisms as classified by the World Health Organization are urgently needed.
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