Author/Editor		Šorli, Jurij
Title		Ambulantno predpisovanje zdravil bolnikom z obstruktivnim sindromom pljuč v Sloveniji
Translated title		Drug prescription to outpatients with obstructive lung diseases in Slovenia
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 65, št. Suppl 2
Publication year		1996
Volume		str. II-25-8
Language		slo
Abstract		Background. Aim of the study were current drug prescription patterns in out-patients with asthma and chronic obstructive pulmonary disease (COPD) in Slovenia, eventual changes in time and complicance with national and international guidelines. Methods. national Institute of Health databank on drug prescription to out-patients was used as a source of information. Statistical analysis of the prescriptions of the group of bronchospasmolitic and antiasthmatic drugs in period 1991-1995 was performed. Data expressed as defined daily dose (DDD) were compared to recommended scheme in national and international guidelines. Results. Important differences in prescription patterns in different age groups were found. Prescriptions in age group over 60 (most evident in age group 80+) were significantly (95 % CI, 0,1-549,9, p=0,001) more frequent compared to the others. Short acting beta2 agonists are the most frequent prescribed drugs in all age groups, while theophyllin prevails in age group over 60. In 1991 drugs in tablets were more often prescribed than in inhalation, with change towards inhalation in 1995. Corticosteroids in inhalation are prescribed less than for 2 months of DDD with children 0-3 years being only exception (4 months of DDD). Positive trend in corticosteroid prescription in 1995 is noticed. Conclusions. Patterns of drug prescription in out-patients with asthma and COPD in Slovenia are in significant contrast to national and international guidelines. Short acting beta2 agonitsts and theophyllin are prescribed on a regular daily basis, most frequent in age groups over 60, while corticosteroids in inhalation are evidently prescribed in intermittently or in too low doses. Prescription of drugs in tablets is more frequent than those in inhalation. Incremental change towards existing guidelines is noticed in 1995. Essentially more effort is recommended to convince physicians to move to more appropriate use of guidelines.
Summary		Izhodišča. Z našo raziskavo smo hoteli ugotoviti, kakšen je vzorec predpisovanja zdravil bolnikom z obstruktivnim sindromom v pljučih v Sloveniji, ali se je s časom spreminjal in v kolikšni meri je prilagojen domačim in svetovnim priporočilom za obravnavo bolnika z astmo in kronično obstruktivno pljučno boleznijo (KOPB). Metode. Uporabili smo podatke vsakoletne avtomatske obdelave ambulantnega predpisovanja zdravil v Sloveniji, ki jo izvaja Inštitut za varovanje zdravja v Ljubljani. V retrospektivni študiji smo s statističnimi metodami analizirali predpis zdravil iz skupine FS 11.4 (zdravila, ki delujejo na bolezni respiratornega sistema - bronhosporazmolitiki, antiastmatiki) v letih 1991-1995. Za primerjalno analizo smo uporabili koncept definiranega dnevnega odmerka zdravila. Dobljene rezultate smo primerjali z domačimi in tujimi priporočili za obravnavo bolnikov z astmo in KOPB. Rezultati. Ugotovili smo, da se vzorec predpisovanja med posameznimi starostnimi skupinami močno razlikuje. Skupini bolnikov nad 60 let (in še posebej tistim nad 80 let) je bilo predpisano bistveno več (95 % CI, 0,1 do 545,9,p=0,001) zdravil kot v ostalih starostnih skupinah. Posebej izstopa predpis kratkoučinkujočih agonistov beta2, v vseh skupinah in posebej teofilinskih preparatov v skupini bolnikov nad 60 letom starosti. Predpis zdravil v obliki tablet je bil leta 1991 enak ali večji kot predpis v pršilu, leta 1995 pa se je razmerje spremenilo v korist zdravil v pršilu. Predpis kortikosteroidov v pršilu je izrazito skromen in ne preseže dvomesečnega definiranega dnevnega odmerka razen v skupini otrok od 0-3 leta starosti, kjer znaša skoraj štirimesečni definirani dnevni odmerek (1, 2). Vendar se predpis kortikosteridov v pršilu med vsemi zdravili skupine FS 11.4 najhitreje povečuje (indeks 1994/95 = 320) Zaključki.Abstract truncated at 2000 characters.
Descriptors		LUNG DISEASES, OBSTRUCTIVE DRUG THERAPY AMBULATORY CARE PRESCRIPTIONS, DRUG GUIDELINES