Author/Editor		Fuerst, Jurij
Title		Predpisovanje zdravil na področju depresije in demence, astme ter protibolečinskih in protivnetnih zdravil
Translated title		Prescribing of antidepressants, drugs for dementia, asthma medications, and analgesics
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 44, št. Suppl 1
Publication year		2005
Volume		str. 167-70
Language		slo
Abstract		Drug consumption analyses enable international and regional comparisons, as well as comparisons between physician groups or individual prescribers. Quality indicators have been developed for prescribing in general practice. Slovenian consumption of drugs is comparable to most developed countries. Wide variations in regional consumption and extreme variations in prescribing among general practitioners have been found. This can indicate a lack of national therapeutic guidelines or insufficient observance of guidelines. The use of antidepressants is increasing but it has not yet reached the Scandinavian level. The most frequently prescribed drugs are selective serotonin reuptake inhibitors. Prescribing of benzodiazepines is higher in Slovenia than in Scandinavian countries. It is 60% higher than in Sweden (in defined daily doses per 1000 inhabitants per dav). Drugs for the treatment of Alzheimer's disease have a limited clinical efficacy. Treatment should be initiated and supervised only by specialists experienced in the management of dementia. In the field of asthma treatment, the use of combined preparations is increasing, while prescribing of inhaled corticosteroids and selective beta2 agonists is decreasing. Among analgesics, the use of paracetamol is generally low, but it is slowly increasing. The use of non-steroidal anti-inflammatory drugs (NSAIDs) is (too) high, but stable. Metamizol is listed as an alternative to NSAIDs. Like paracetamol, it is indicated for patients with gastrointestinal side effects.
Summary		Spremljanje porabe zdravil omogoča mednarodne primerjave, primerjave med regijami, skupinami zdravnikov in med posameznimi zdravniki. Na osnovi izbranih kazalcev o predpisanih zdravilih je mogoče sklepati o kakovosti dela zdravnikov. Poraba zdravil v Sloveniji je primerljiva z najrazvitejšimi državami, značilne pa so velike razlike med regijami ter izjemne razlike pri predpisovanju med posameznimi zdravniki. To lahko kaže na pomanjkanje nacionalnih terapevtskih smernic oz. na nezadostno sledenje smernicam. Poraba antidepresivov v zadnjih letih vseskozi narašča, vendar ne dosega porabe v Skandinaviji. Najpogosteje se uporabljajo selektivni zaviralci privzema serotonina. Z večjo porabo antidepresivov pa ne upada predpisovanje benzodiazepinov, ki jih predpisujemo mnogo pogosteje kot v Skandinaviji, npr. na prebivalca kar 60% več kot na Švedskem. Zdravila za zdravljenje Alzheimerjeve bolezni imajo le omejeno klinično učinkovitost, zato je nujno, da jih indicira in zdravljenje nadzoruje specialist, izveden v zdravljenju demence. Zdravljenje astme gre v smeri kombiniranih pripravkov. Poraba bronhoselektivnih agonistov beta-2-adrenergičnih receptorjev in inhalacijskih glukokortikoidov se je znižala. Med protibolečinskimi zdravili poraba paracetamola le skromno narašča, poraba nesteroidnih protivnetnih zdravil (NSAR) pa ostaja enako (pre)visoka. Kot alternativa NSAR in dodatna možnost za zdravljenje bolnikov z bolečinami, je na listo zdravil ponovno razvrščen metamizol, ki je podobno kot paracetamol primeren za vse bolnike, ki imajo želodčne težave.
Descriptors		DRUG UTILIZATION PRESCRIPTIONS, DRUG ANTIDEPRESSIVE AGENTS ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL ASTHMA DEMENTIA