drug utilization studies
TRANSCRIPT
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DRUG UTILIZATION STUDIES
DR.RENJU.S.RAVI MD
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OVERVIEW Introduction Definition Aims & Objectives Types of drug use information Targets Tools used DUE Sources of data on DU Future perspectives.
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INTRODUCTION
Developed in mid 1960s in Northern Europe & UK.
Pioneering work by Arthur Engel in Sweden & Pieter Siderius in Holland.
Ultimate goal was to assess rational drug therapy.
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DEFINITION
“the marketing , distribution , prescription ,
and the use of drugs in a society with special
emphasis on the resulting medical , social and
economic consequences”.
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AIMS & OBJECTIVES
Description of drug use patterns
Early signals of irrational drug
use
Interventions to improve drug use
Quality control of drug use
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Description of drug use patterns Estimating the no: of patients exposed to drugs in a given time
period. Extent of drug use at a certain moment and/or certain area. Extent of drug usage – proper/overuse/underuse Drug use profile – assessing alternative drugs. Comparing observed patterns of drug use to current guide lines. Feed back to prescribers on DU data. Relating the no: of case reports about adverse effects to the no: of
pts exposed to assess the magnitude of the problem.
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Early signals of IRRATIONAL DRUG USE
Helps to generate hypotheses for further drug investigations.
Comparing drug utilization patterns and costs b/w different regions or time periods.
Comparing observed patterns of drug use to current recommendations/guidelines.
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Interventions to improve drug use Monitoring and evaluating the improvement
measures- information campaigns , regulatory policies.
Following the impact of regulatory changes / changes in insurance/reimbursement systems.
Assessing promotional activities of pharmaceutical industry, educational activities of society’s impact on pattern of drug use.
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Quality control of drug usePLAN
Analyse current situation to establish
a plan for improvemen
DOImplement plan on a
small scale
CHECKCheck for the
expected results
ACTRevise or implement plan on large scale
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Types of drug information
Drug based information
Problem or encounter-based information
Patient information
Prescriber information
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TARGETS Systems and structures surrounding drug use
Processes of drug use Outcomes of drug use
TYPES Quantitative Qualitative1. Cross-sectional study2. Longitudinal3. Continuous longitudinal
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TOOLS USED
WHO’s drug use indicators
Drug classification systems
Defined daily systems
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Drug Utilization Evaluation OBJECTIVES
1. Ensuring current drug therapy
2. Controlling drug cost
3. Preventing problem related to medication
4. Evaluating the effectiveness of drug therapy
5. Identification of areas of practice that require further education of practitioners
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DUE Classification
PROSPECTIVE
CONCURRENT
RETROSPECTIVE
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Sources of data on drug utilization1. Large data base
2. Data from drug regulatory agencies
3. Supplier/distribution data
4. Practice setting data
a) Prescribing data
b) Dispensing data
c) Aggregate data
d) OTC & Pharmacist-prescribed drugs
e) Telephone & Internet prescribing
5. Community setting data.
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Future Perspectives
1. Public health – diff b/w national & international patterns
of drug utilization requires further study.
2. Pharmacovigilance – DU data can be used to perform
screening pts with ↑ risk for drug induced illnesses.
3. Pharmacoeconomics – by adhering to current guidelines
reduce drug expenditure & improve limited resources.
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4. Eco pharmacovigilance – pharmaceuticals are
environmental pollutants care to be taken to ↓
environmental impacts while delivering patient
benefit.
5. Pharmacogenetics – assessing genetic mechanisms
related to drug safety, comparing pts characteristics
to the benefit and risk of drugs.
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THANK YOU