Operacionalizando conceitos em farmacoepidemiologia : estudos de utilização de medicamentos e de farmacovigilancia

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

BACKGROUND: In all phases of the process of development of a new medicine the drug safety and the profile of adverse drug reactions it is always object of a lot of attention. Though, even with all the methodological concerns, when a drug goes to the postmarketing phase, a small number of patients were exposed indeed to the new drug. Pharmacoepidemiology uses as tool mainly the Drug Utilization Studies (DUS) and the Pharmacovigilance studies (FV). Two studies were proposed. The first was a hospital-based intensive monitoring and the second was a DUS about antipsychotic consumption. FIRST STUDY: The first study was carried out in two steps. The first step, evaluated the Internal Medicine ward s morbidity patterns available in the hospital register system during 1997. The second step was carried out in 1999 when a hospital-based intensive monitoring program was performed during a 4 months period. Patients admitted to this ward were interviewed for the drugs used during 15 days before admission, their morbidity patterns were described in detail, and the possibility of adverse drug reactions being the cause of hospital admission was evaluated. RESULTS: In 1997, the Internal Medicine ward had 938 hospital admissions, 53,4% were male admissions and a median of 1.1 diagnoses per admission. No adverse drug reaction diagnose was found. The hospital-based intensive monitoring showed 135 patients that met the criteria s selection, 52% were female, 92% of the patients used drugs before the hospital admission, and 42% of these were selfmedication. The median of drug use was 3.7. Adverse drug reaction was implicated in 6.6% of hospital admissions. CONCLUSIONS: The hospital-based intensive monitoring improved the reporting of drug adverse reactions and it is an important teaching source for the rational drug use. SECOND STUDY: It analyzed data of antipsychotic drugs conswnption using the registrations that came fiom database of conswnption of drugs. Retrospective study of done m Denmark usmg the data of Odense Pharmacoepidemiological Database (OPED) among the years fiom 1993 to 1999. RESULTS: The prevalence ofthe use ofthese drugs is falling significantly, in 1993 it was of 31,670/00and in 1999 it was of 24,99%0.In the same way the incidence is fal1ingtoo, in 1994 it was of 9,98%0and in 1999 of 7,41%0.Women used higher doses of antipsychotic than men when consider the Defined Daily Dose (DDD) per 1,000 inhabitants. CONCLUSION: In the last years the Danish pharmaceutical market suffered alterations with the introduction of new antidepressants. Once antipsychotics potentially could be being used in the treatment of certain depression types, such fact could justify the fall at least partially in the antipsychotic consumption and allies the accomplishment of educational measures for the family doctors focusing the rational use of drugs that had been held. GENERAL CONCLUSION: DUS and FV they are important tools for a safer and rational therapeutics, being added this, the rationality in the allocation of the available resources at all levels of the health services. They answer important concems about the safety and effectiveness of the drugs

ASSUNTO(S)

farmacologia clinica hospitais

ACESSO AO ARTIGO

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