Comparison of drug prescribing before and during the COVID‐19 pandemic : a cross‐national European study

Purpose: The COVID-19 pandemic had an impact on health care, with disruption to routine clinical care. Our aim was to describe changes in prescription drugs dispensing in the primary and outpatient sectors during the first year of the pandemic across Europe. Methods: We used routine administrative data on dispensed medicines in eight European countries (five whole countries, three represented by one region each) from January 2017 to March 2021 to compare the first year of the COVID-19 pandemic with the preceding 3 years. Results: In the 10 therapeutic subgroups with the highest dispensed volumes across all countries/regions the relative changes between the COVID-19 period and the year before were mostly of a magnitude similar to changes between previous periods. However, for drugs for obstructive airway diseases the changes in the COVID-19 period were stronger in several countries/regions. In all countries/regions a decrease in dispensed DDDs of antibiotics for systemic use (from −39.4% in Romagna to −14.2% in Scotland) and nasal preparations (from −34.4% in Lithuania to −5.7% in Sweden) was observed. We observed a stockpiling effect in the total market in March 2020 in six countries/regions. In Czechia the observed increase was not significant and in Slovenia volumes increased only after the end of the first lockdown. We found an increase in average therapeutic quantity per pack dispensed, which, however, exceeded 5% only in Slovenia, Germany, and Czechia. Conclusions: The findings from this first European cross-national comparison show a substantial decrease in dispensed volumes of antibiotics for systemic use in all countries/regions. The results also indicate that the provision of medicines for common chronic conditions was mostly resilient to challenges faced during the pandemic. However, there were notable differences between the countries/regions for some therapeutic areas

Establecimiento de los conocimientos, actitudes y opiniones de la población sobre el uso racional de medicamentos

Objetivo: Identificar el nivel de conocimientos, actitudes y opiniones respecto al uso de medicamentos (UM) en población general. Método: Estudio descriptivo transversal, cuantitativo, realizado en usuarios de la sanidad pública ≥ 18 años asignada a centros de atención primaria de la ciudad de Barcelona. Muestreo bietápico, estratificación: barrio, sexo y edad. Administración presencial de un cuestionario propio validado. Análisis: SPSSv15. Período estudio: diciembre 2011. Resultados: Cuatrocientas ochenta y cuatro encuestas (IC 95%, α = 5%). 53% mujeres; 21,3% estudios universitarios. UM: 81% ha tomado medicamentos en los últimos 3 meses; media, 1,9. Conceptos técnicos: El 80% de los que se medican saben indicar qué medicamentos toman y para qué. En el 90% de los casos no saben indicar el nombre del principio activo (pa). El 55,6% no sabe definir el concepto pa. Sólo un 35% reconoce algún pa indicado en el envase de tres medicamentos diferentes y un 44,5% no reconoce ninguno. El 22,7% conoce el significado de contraindicación, efecto adverso e interacción medicamentosa. El 20% tiene total desconocimiento y este aumenta con la edad y disminuye con el nivel de estudios. Opinión y actitud: Valor del indicador global de uso racional (IGUR) de medicamentos, 5,03 puntos: 6,18 praxis, 5,02 información, 3,85 uso sostenible y 3,49 nuevos medicamentos/genéricos. El 70% de los encuestados cree que no se hace un uso racional de medicamentos y el 21,3% cree que es necesaria mayor concienciación social. Conclusiones: Los conocimientos, actitudes y opiniones de los ciudadanos sobre medicamentos son bajos. Es necesario implicar a los ciudadanos y mejorar sus conocimientos básicos para avanzar en el uso racional

International trends in antipsychotic use:A study in 16 countries, 2005-2014

The objective of this study was to assess international trends in antipsychotic use, using a standardised methodology. A repeated cross-sectional design was applied to data extracts from the years 2005 to 2014 from 16 countries worldwide. During the study period, the overall prevalence of antipsychotic use increased in 10 of the 16 studied countries. In 2014, the overall prevalence of antipsychotic use was highest in Taiwan (78.2/1000 persons), and lowest in Colombia (3.2/1000). In children and adolescents (0-19 years), antipsychotic use ranged from 0.5/1000 (Lithuania) to 30.8/1000 (Taiwan). In adults (20-64 years), the range was 2.8/1000 (Colombia) to 78.9/1000 (publicly insured US population), and in older adults (65+ years), antipsychotic use ranged from 19.0/1000 (Colombia) to 149.0/1000 (Taiwan). Atypical antipsychotic use increased in all populations (range of atypical/typical ratio: 0.7 (Taiwan) to 6.1 (New Zealand, Australia)). Quetiapine, risperidone, and olanzapine were most frequently prescribed. Prevalence and patterns of antipsychotic use varied markedly between countries. In the majority of populations, antipsychotic utilisation and especially the use of atypical antipsychotics increased over time. The high rates of antipsychotic prescriptions in older adults and in youths in some countries merit further investigation and systematic pharmacoepidemiologic monitoring