Russo, Veronica
(2020)
Drug utilization studies as a strategy for the quality assessment of medication use.
[Tesi di dottorato]
| Tipologia del documento: |
Tesi di dottorato
|
| Lingua: |
English |
| Titolo: |
Drug utilization studies as a strategy for the quality assessment of medication use |
| Autori: |
| Autore | Email |
|---|
| Russo, Veronica | veronica.russo@unina.it |
|
| Data: |
7 Marzo 2020 |
| Numero di pagine: |
176 |
| Istituzione: |
Università degli Studi di Napoli Federico II |
| Dipartimento: |
Farmacia |
| Dottorato: |
Scienza del farmaco |
| Ciclo di dottorato: |
32 |
| Coordinatore del Corso di dottorato: |
| nome | email |
|---|
| D'Auria, Maria Valeria | madauria@unina.it |
|
| Tutor: |
| nome | email |
|---|
| Menditto, Enrica | [non definito] |
|
| Data: |
7 Marzo 2020 |
| Numero di pagine: |
176 |
| Parole chiave: |
Drug-utilisation, PIP, Geographical difference, Prevalence, drug use, General practitioner, PIM, DDI |
| Settori scientifico-disciplinari del MIUR: |
Area 03 - Scienze chimiche > CHIM/09 - Farmaceutico tecnologico applicativo |
[error in script]
[error in script]
| Depositato il: |
19 Mar 2020 11:24 |
| Ultima modifica: |
10 Nov 2021 14:09 |
| URI: |
http://www.fedoa.unina.it/id/eprint/13021 |
Abstract
Drug prescribing is a vital part of the whole healthcare system.
However, the processes involved in choosing an appropriate drug treatment are complex and lots of drugs are often prescribed and used in inappropriate ways, especially in the older people. The immediate consequences of inappropriate prescribing are diverse and include: an increment in negative drug events, hospitalization and mortality rates, healthcare resource wastage, and additional healthcare costs.
The present thesis describes the results of the first phase of the ongoing national collaborative project (EDU.RE.DRUG Project) founded by the Italian Medicine Agency (AIFA).
The EDU.RE.DRUG Project (Effectiveness of informative and/or educational interventions aimed at improving the appropriate use of drugs designed for general practitioners and their patients) aims to deeply investigate the prescribing practice among general practitioners (GPs) and the appropriate drug use by their patients in two Italian regions.
In accordance with the first phase of the EDU.RE.DRUG Project, the main objectives of this thesis are: (i) to develop indicators of inappropriate prescribing suitable to the Italian context; (ii) to retrospectively assess the prevalence of drug use of selected drug classes, with a particular focus on older patients; (iii) to compare two different geographical areas in Italy; (iv) to investigate the influence of socioeconomic and sociodemographic variables on prevalence of drug use for each of the selected drug categories.
Within the framework of the present research project, a set of explicit indicators was defined so to identify potential inappropriate prescription and drug use. The set of indicators was adapted to the Italian drug market, providing, in this manner, a tool specifically tailored to the characteristics of the Italian healthcare system.
Besides providing specifically tailored indicators, an analysis of quality prescribing has been performed by employing data coming from two different Italian regions. In this context, we also retrospectively assessed geographical variations in drug prescription across selected drug classes (those specifically targeting aged people).
Many differences arise between the two regions involved in the study. In general, compared to Lombardy LHUs (in the North of Italy), patients belonging to the Campania LHUs (in the South of Italy) are exposed to higher prevalence rate for all selected drug categories.
Particularly, the drug category that showed the highest geographical variability was antibiotics.
It is interesting to note that such geographical variability has been found not only among different Italian regions, but also among areas within the same region.
In most of the southern municipalities of Campania (e.g. Benevento and Salerno), prevalence rates and antibiotic consumption were lower than in coastal areas around Naples and eastern Avellino (from 15,2% in Omignano, Sa-LHU, to 61,9% in Moschiano, Av-LHU).
Furthermore, our study showed that socio-economic and socio-demographic factors can influence the appropriateness of drug use.
The intraregional variability observed in our study can also be explained by different prescribing patterns among physicians and different local health policies.
These results show the pressing need for an intervention aimed at improving the quality of prescribing and drug use. In this regard, the strategies necessary to the optimization of drug prescribing could benefit from the analysis provided by the present work.
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