Spelling suggestions: "subject:"drug utilisation review"" "subject:"rug utilisation review""
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A retrospective analysis of the prescribing patterns of hipolipidaemic drugs : a pharmacoeconomic approach / J. Bloem.Bloem, Johann January 2009 (has links)
Background: More than 5.5 million South Africans aged 30 years and older are at risk of chronic disease by virtue of their triglyceride levels (Maritz, 2006:101). Dyslipidaemia is common in westernized and industrialized communities (Steyn et al., 2000:720), especially so for South Africa, where burden of disease data show dyslipidaemia to be the second most prevalent of all the chronic conditions in the country (Council for Medical Schemes, 2006:48). It is therefore no surprise that at 3.3 per cent hipolipidaemics ranked second highest based on prevalence percentage per therapeutic group in the 2005 Mediscor medicines review on South African medical claims data (Bester et al., 2005:8-11). Hipolipidaemic drugs subsequently also ranked second highest for expenditure per therapeutic group, achieving a total expenditure of 5.8 per cent.
Objective: The purpose of this study was to characterise the usage and cost of hipolipidaemic drugs in the private health care environment in South Africa based on various categories, including age, sex, prescriber type and generic indicator.
Methods: A quantitative retrospective drug utilisation review was performed using dispensing records from a medicine claims database. Data for a two-year period (1 Jan. 2005 to 31 Dec. 2006) were used. Hipolipidaemic medicine usage was analysed according to five patient age strata: patients younger than 9 years, 10 ≤ 19 years, 20 ≤ 45 years, 46 ≤ 59 years and older than 59 years.
Basic descriptive statistics such as frequencies and arithmetic mean (average) were used to characterise the study sample, and were calculated using the Statistical Analysis System (SAS®) for Windows 9.1® program (SAS Institute Inc., 2002-2003).
Results: The database consisted of 19 860 593 and 21 473 062 medicine item claims for 2005 and 2006 respectively, at a total cost of R 1 893 376 921.00 (for 2005) and R2 046 944 383.00 (for 2006). Patients receiving hipolipidaemic medicine items represented about 7.2% of the
total number of patients on the database in both 2005 and 2006. About 47% of the study population in both 2005 and 2006 was female, compared to 53% males.
Hipolipidaemics represented between 3.1% (N = 19 860 593) and 3.3% (N = 21 473 062) of the total number of items claimed during the study period. The total cost of hipolipidaemics accounted for between 5.6% (N = R1 893 376 921.00) and 5.8% (N = R2 046 944 383.00) of the total cost of all medications claimed during the study period. The average cost per item of hipolipidaemics was R170.63 ± 70.19 in 2005 compared to R167.08 ± 71.93) in 2006. HMG-CoA reductase inhibitors formed the leading therapeutic class in hipolipidaemic medicine items in all age groups on the database, except for children aged 0 ≤ 9 years, where the “others” group, in particular cholestyramine (Questran Lite 4 mg) was claimed more frequently. Of the items claimed for both study periods, simvastatin was the most commonly claimed, accounting for 45.35% (n = 284 232) and 46.21% (n = 325 970) respectively of the number of hipolipidaemic items claimed, at a total cost of 30.97% (n = R33 119 294.18) and 31.38% (n = R36 983 938.41) for 2005 and 2006 respectively.
Non-substitutable and generic hipolipidaemic medicine items carried the largest percentage of prevalence and cost in both study periods for both sex categories and all age groups. The majority of claims for hipolipidaemic medicine items were prescribed by general medical practitioners, followed by “other prescribers” and then by cardiologists. Only a small number of prescriptions claimed were prescribed by thoracic surgeons and even fewer by pharmacotherapists and pharmacists. Trade name products that were mostly prescribed were Lipitor and Adco-Simvastatin.
Of all the hipolipidaemic drugs utilised on the database, only three active ingredients (bezafibrate, simvastatin and pravastatin) had generic equivalents available at the time of the study. With total substitution (100%) of these three drugs with the average price of the available generic hipolipidaemic equivalents on the database, a cost saving of R1 744 462.27 or 1.63% (N = R106 943 348.53) was possible in 2005. In 2006, a total cost saving of R1 526 985.79 or 1.30% (N = R117 862 631.87) was calculated.
Conclusion: The study highlighted the most commonly prescribed hipolipidaemics within a sub-population of South African patients. The high average cost per prescription of hipolipidaemic drugs indicates that they are relatively expensive in comparison to other medications. Generic (and therapeutic) substitution should be investigated as potential cost-saving mechanisms in the private health care sector of South Africa. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2010.
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The treatment of paediatric asthma in the private health care sector of South Africa : a retrospective drug utilisation review / J. MoutonMouton, Jeanine January 2010 (has links)
Asthma is the most common chronic disease among children worldwide. The prescribing
patterns of the medication used to treat asthma in South Africa, as well as the prevalence of
paediatric asthma are of interest and need to be investigated.
A drug utilisation review was performed to determine the prevalence of asthma, and in
particular paediatric asthma in a section of the private health care sector of South Africa. The
prescribing patterns of asthma medication were investigated according to different
demographic factors, such as gender, geographical area and prescriber type. Data from a
medical claims database were extracted and processed to reveal the different prescribing
patterns from 1 January 2005 to 31 December 2008. Medication from the MIMS®
pharmacological groups 10.2 and 10.4 were used as a basis for asthma medication. Patients
had to use at least one medicine item from one of these groups to be included in the study.
The prevalence of asthma in the general population showed an increase from 2005 to 2008.
The prevalence of asthma as a part of the total database according to the number of patients
increased from 23.01% in 2005 (n=347342) to 24.72% in 2008 (n=240854), although the
number of patients on the total database decreased from 2005 to 2008. When investigating
the number of prescriptions that were dispensed during 2008, asthma prescriptions
comprised 7.16% (n=484983) of all prescriptions and the number of asthma medicine items
that were dispensed made up 3.72% (n=611139) of the total number of medicine items
dispensed in 2008.
Paediatric asthma was divided into two age groups for the purpose of this study namely, 0 -
4 years of age and older than 4 years, but younger or equal to 11 years of age ( >4 - 11
years), according to a previous study done by the National Heart Lung and Blood Institute
(NHLBI). The results from the data confirmed that the prevalence of asthma was higher in
the younger age group. The number of patients using asthma medication in the 0 - 4 years
age group comprised 44.40% (n=11306) of the total number of patients in this age group on
the database in 2008, compared to 32.84% (n=28347) in the >4 - 11 years age group.
Asthma was more common among male patients, whether they were included in the
paediatric groups or not. The geographical distribution of paediatric asthma seemed to be
connected to the provinces without coastlines and different mining facilities. The combination of asthma medication with antibiotics and systemic corticosteroids were investigated and it
was concluded that antibiotics that were used for respiratory tract infections were prescribed
the most frequently to asthma patients.
The refill–adherence rates of patients with asthma were not satisfactory when considering
that asthma is a chronic disease. The average adherence rate for all the asthma products
that were brought into account when calculating the refill–adherence rate was 60.95%. A rate
above 90% indicates optimal patient adherence.
In conclusion this study determined that asthma has a significant prevalence among children
in South Africa. The prescribing patterns for the different medication used in the treatment of
asthma were investigated and recommendations for further research in this field of study
were made. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.
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Prescribing patterns of methylphenidate and atomoxetine containing products in a section of the private health care sector of South Africa / Stephan RothmannRothmann, Stephan January 2009 (has links)
The general aim of this study was to investigate the prescribing patterns of products that contain methylphenidate or atomoxetine in a section of the private health care sector of South Africa. A quantitative, retrospective drug uitilisation review was performed according to data obtained from the database of a South African medicine claims pharmacy benefit management company's for three consecutive study years (Le. 2005 to 2007).
The results indicated that a total of 7,990 patients had been prescribed products that contained methylphenidate or atomoxetine in 2005. The total for 2006 was 8,575 and it decreased to a total of 7,828 in 2007. Of all the patients who received the mentioned products, the percentage for females increased from 27.75% (N = 7,990) in 2005 to 29.06% (N =7,828) in 2007. With regard to the same products the percentage for males decreased from 72.03% (N = 7,990) in 2005 to 70.89% (N = 7,828) in 2007. The ratio for the gender-related prescribing patterns of medicine items that contained methylphenidate or atomoxetine in this section of the private health care sector of South Africa was ± 2.55:1 for males to females in comparison with the international male:female ratio of 3:1.
According to the medicine claims on the database for 2005 the total number of prescriptions that indicated products containing methylphenidate or atomoxetine was calculated as 8,522, 798 (i.e. N = 8, 522,798) or as a percentage of 0.32% prescriptions. The percentage showed an increase to 0.41 % in 2007 (N = 8,015,538). Of all the medicine items containing methylphenidate or atomoxetine those products that contained atomoxetine represented 4.69% and those that contained methylphenidate represented 95.31%. In 2005 the average cost per prescription that indicated items containing methylphenidate or atomoxetine amounted to R318.29 ± R162.09. In 2007 the amount increased to R358.91 ± R208.10.
The percentage of children younger than five years of age, and who had been prescribed products containing methylphenidate or atomoxetine, increased from 0.91 % in 2005 (N = 7,990) to 1.11 % in 2007 (N =7,828). The percentage for children aged 5 to 12 years decreased from 53.62% in 2005 to 49.23% in 2007. For adolescents the percentage increased from 26.32% in 2005 to 27.35% in 2007. The same pattern repeated itself in the case of adults (age 18+ years).
Among the top trade name products prescribed were Ritalin LA 20mg®, Ritalin 20mg®, Concerta 36mg®, Ritalin LA 30mg® and Concerta 18mg®.
Possible drug-drug interactions were found between products containing methylphenidate or atomoxetine and products containing imipramine, amitriptyline and carbamazepine.
Findings indicated that the number of products containing methylphenidate or atomoxetine increased from 2005 to 2007, while also revealing that those products containing methylphenidate remained in the majority. The average costs of products containing methylphenidate or atomoxetine increased from 2005 to 2007. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2010.
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A review of the prescribing patterns of combination analgesics in the private health care sector / Hanlie KrugerKruger, Hanlie January 2007 (has links)
South African prescribers have a large choice of combination analgesic preparations available for prescribing. According to Desmeules et al. (2003:8) the advantages of combining analgesics include increasing the duration of analgesia, widening the spectrum of efficacy, improved patient compliance and reduced parenteral abuse potential. According to McMahon (1975:13) one of the principle arguments against fixed-dose combinations is that the physician surrenders flexibility in managing his patient. Combination analgesics may expose patients to ingredients not necessary for pain relief in their particular condition (Beaver, 1984).
Rigas (1997:454) explains that the value of pharmaco-economics in providing cost-effective pharmacologic treatment for pain must not only be seen as a containment effort, but rather as a valuation effort. Meaningful economic analyses based on empiric information about cost and a range of subjective and objective outcomes are needed to minimise cost without compromising care.
The objective of this study was to review and interpret the prescribing patterns of combination analgesics and the cost associated with their usage for the period 2001-2006 in a section of the private healthcare sector in South Africa. This research can be classified as a quantitative, retrospective drug utilisation review study. Data were obtained from a medicine claims database, and the study population consisted of all combination analgesic prescriptions (Mims® category 3.3) for the period 1 January 2001 to 31 December 2002 and 1 January 2004 to 31 December 2006.
Prescribing Patterns of Combination Analgesics in the Private Health Care Sector.
Firstly pain and the treatment thereof with combination analgesics were investigated from the literature to understand the disease and to determine the prevalence and treatment thereof. Secondly, managed health care, drug utilisation review, pharmacoeconomics and pharmaco-epidemiology were investigated from the literature to understand these concepts. The influence of the South African government on the medicine pricing regulations was discussed.
Thirdly, through the empirical investigation the utilisation patterns of combination analgesics were reviewed, analysed and interpreted. It was determined that combination analgesic drugs represented 8.87% (n=261 907) of all medicine claimed during 2001 (N=2 951 326), decreased to 7.20% (n=381 809) during 2004 (N=5 305 846) after which it increased to 7.92% (n=187 745) in 2006 (N=2 370 572). Between 2001 (N=R379 708 489.00) and 2006 (N=R279 160 832.00) the cost percentage of the combination analgesic drugs decreased from 4.95% (n=R18 798 202.42) to 3.15% (n=R8 791 228.57).
The average cost per combination analgesic drugs decreased from R71.77 ± 61.67 to R46.83 ± 43.41 between 2001 and 2006. This decrease was of no practical significance (d<0.8). The average number of combination analgesics per prescription stayed relatively constant varying between 1.01 ± 0.11 in 2001 and 1.02 ± 0.13 in 2006.
The percentage generic combination analgesic drugs claimed increased from 29.63% (n=77 608) in 2001 to 66.37% (n=124 600) in 2006 (N=261 907 for 2001 and N=187 745 for 2006) even though generic medicine items claimed by the total database only increased from 26.79% (n=790 548) in 2001 to 40.27% (n=954 561) during 2006 (N=2 951 326 for 2001 and N=2 370 572 for 2006).
The combination of ibuprofen 200mg, paracetamol 250mg and codeine phosphate 10mg (e.g. Myprodol® capsules, Mybulen® capsules, Gen-payne® capsules and Ibupain Forte® capsules) represented the active ingredient combination with the highest prevalence for the entire study period, increasing from 28.44% (n=74 483) in 2001 to 33.08% (n=62 100) in 2006 of all combination analgesics prescribed (N=261 907 for 2001 and N=187 745 for 2006).
Generic substitution influenced the prevalence of the innovator medicine item, Myprodol® Capsules dramatically, causing a decrease from 23.16% (n=60 631) in 2001 to 3.77% (n=7 084) in 2006 representation of all combination analgesic prescribed. In 2006, the generics of Myprodol® Capsules e.g. Dentopain Forte®, Mybulen® Capsules, Gen-payne® and Ibupain Forte® represented 23.79% (n=44651) of all combination analgesics claimed.
Recommendations were derived regarding certain aspects of the clinical and economical management of pain e.g. the implication of generic substitution with regard to cost and prescribing patterns, and the decreasing cost of combination analgesics which might encourage abuse, needs further investigation.
South African prescribers have a large choice of combination analgesic preparations available for prescribing. According to Desmeules et al. (2003:8) the advantages of combining analgesics include increasing the duration of analgesia, widening the spectrum of efficacy, improved patient compliance and reduced parenteral abuse potential. According to McMahon (1975:13) one of the principle arguments against fixed-dose combinations is that the physician surrenders flexibility in managing his patient. Combination analgesics may expose patients to ingredients not necessary for pain relief in their particular condition (Beaver, 1984).
Rigas (1997:454) explains that the value of pharmaco-economics in providing cost-effective pharmacologic treatment for pain must not only be seen as a containment effort, but rather as a valuation effort. Meaningful economic analyses based on empiric information about cost and a range of subjective and objective outcomes are needed to minimise cost without compromising care.
The objective of this study was to review and interpret the prescribing patterns of combination analgesics and the cost associated with their usage for the period 2001-2006 in a section of the private healthcare sector in South Africa. This research can be classified as a quantitative, retrospective drug utilisation review study. Data were obtained from a medicine claims database, and the study population consisted of all combination analgesic prescriptions (Mims® category 3.3) for the period 1 January 2001 to 31 December 2002 and 1 January 2004 to 31 December 2006.
Prescribing Patterns of Combination Analgesics in the Private Health Care Sector.
Firstly pain and the treatment thereof with combination analgesics were investigated from the literature to understand the disease and to determine the prevalence and treatment thereof. Secondly, managed health care, drug utilisation review, pharmacoeconomics and pharmaco-epidemiology were investigated from the literature to understand these concepts. The influence of the South African government on the medicine pricing regulations was discussed.
Thirdly, through the empirical investigation the utilisation patterns of combination analgesics were reviewed, analysed and interpreted. It was determined that combination analgesic drugs represented 8.87% (n=261 907) of all medicine claimed during 2001 (N=2 951 326), decreased to 7.20% (n=381 809) during 2004 (N=5 305 846) after which it increased to 7.92% (n=187 745) in 2006 (N=2 370 572). Between 2001 (N=R379 708 489.00) and 2006 (N=R279 160 832.00) the cost percentage of the combination analgesic drugs decreased from 4.95% (n=R18 798 202.42) to 3.15% (n=R8 791 228.57).
The average cost per combination analgesic drugs decreased from R71.77 ± 61.67 to R46.83 ± 43.41 between 2001 and 2006. This decrease was of no practical significance (d<0.8). The average number of combination analgesics per prescription stayed relatively constant varying between 1.01 ± 0.11 in 2001 and 1.02 ± 0.13 in 2006.
The percentage generic combination analgesic drugs claimed increased from 29.63% (n=77 608) in 2001 to 66.37% (n=124 600) in 2006 (N=261 907 for 2001 and N=187 745 for 2006) even though generic medicine items claimed by the total database only increased from 26.79% (n=790 548) in 2001 to 40.27% (n=954 561) during 2006 (N=2 951 326 for 2001 and N=2 370 572 for 2006).
The combination of ibuprofen 200mg, paracetamol 250mg and codeine phosphate 10mg (e.g. Myprodol® capsules, Mybulen® capsules, Gen-payne® capsules and Ibupain Forte® capsules) represented the active ingredient combination with the highest prevalence for the entire study period, increasing from 28.44% (n=74 483) in 2001 to 33.08% (n=62 100) in 2006 of all combination analgesics prescribed (N=261 907 for 2001 and N=187 745 for 2006).
Generic substitution influenced the prevalence of the innovator medicine item, Myprodol® Capsules dramatically, causing a decrease from 23.16% (n=60 631) in 2001 to 3.77% (n=7 084) in 2006 representation of all combination analgesic prescribed. In 2006, the generics of Myprodol® Capsules e.g. Dentopain Forte®, Mybulen® Capsules, Gen-payne® and Ibupain Forte® represented 23.79% (n=44651) of all combination analgesics claimed.
Recommendations were derived regarding certain aspects of the clinical and economical management of pain e.g. the implication of generic substitution with regard to cost and prescribing patterns, and the decreasing cost of combination analgesics which might encourage abuse, needs further investigation. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2008.
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Overview of antidepressant usage and cost 2004 until 2006 / E. van der WesthuizenVan der Westhuizen, Elmarie January 2007 (has links)
Thesis (M. Pharm.)--North-West University, Potchefstroom Campus, 2008.
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A retrospective analysis of the prescribing patterns of hipolipidaemic drugs : a pharmacoeconomic approach / J. Bloem.Bloem, Johann January 2009 (has links)
Background: More than 5.5 million South Africans aged 30 years and older are at risk of chronic disease by virtue of their triglyceride levels (Maritz, 2006:101). Dyslipidaemia is common in westernized and industrialized communities (Steyn et al., 2000:720), especially so for South Africa, where burden of disease data show dyslipidaemia to be the second most prevalent of all the chronic conditions in the country (Council for Medical Schemes, 2006:48). It is therefore no surprise that at 3.3 per cent hipolipidaemics ranked second highest based on prevalence percentage per therapeutic group in the 2005 Mediscor medicines review on South African medical claims data (Bester et al., 2005:8-11). Hipolipidaemic drugs subsequently also ranked second highest for expenditure per therapeutic group, achieving a total expenditure of 5.8 per cent.
Objective: The purpose of this study was to characterise the usage and cost of hipolipidaemic drugs in the private health care environment in South Africa based on various categories, including age, sex, prescriber type and generic indicator.
Methods: A quantitative retrospective drug utilisation review was performed using dispensing records from a medicine claims database. Data for a two-year period (1 Jan. 2005 to 31 Dec. 2006) were used. Hipolipidaemic medicine usage was analysed according to five patient age strata: patients younger than 9 years, 10 ≤ 19 years, 20 ≤ 45 years, 46 ≤ 59 years and older than 59 years.
Basic descriptive statistics such as frequencies and arithmetic mean (average) were used to characterise the study sample, and were calculated using the Statistical Analysis System (SAS®) for Windows 9.1® program (SAS Institute Inc., 2002-2003).
Results: The database consisted of 19 860 593 and 21 473 062 medicine item claims for 2005 and 2006 respectively, at a total cost of R 1 893 376 921.00 (for 2005) and R2 046 944 383.00 (for 2006). Patients receiving hipolipidaemic medicine items represented about 7.2% of the
total number of patients on the database in both 2005 and 2006. About 47% of the study population in both 2005 and 2006 was female, compared to 53% males.
Hipolipidaemics represented between 3.1% (N = 19 860 593) and 3.3% (N = 21 473 062) of the total number of items claimed during the study period. The total cost of hipolipidaemics accounted for between 5.6% (N = R1 893 376 921.00) and 5.8% (N = R2 046 944 383.00) of the total cost of all medications claimed during the study period. The average cost per item of hipolipidaemics was R170.63 ± 70.19 in 2005 compared to R167.08 ± 71.93) in 2006. HMG-CoA reductase inhibitors formed the leading therapeutic class in hipolipidaemic medicine items in all age groups on the database, except for children aged 0 ≤ 9 years, where the “others” group, in particular cholestyramine (Questran Lite 4 mg) was claimed more frequently. Of the items claimed for both study periods, simvastatin was the most commonly claimed, accounting for 45.35% (n = 284 232) and 46.21% (n = 325 970) respectively of the number of hipolipidaemic items claimed, at a total cost of 30.97% (n = R33 119 294.18) and 31.38% (n = R36 983 938.41) for 2005 and 2006 respectively.
Non-substitutable and generic hipolipidaemic medicine items carried the largest percentage of prevalence and cost in both study periods for both sex categories and all age groups. The majority of claims for hipolipidaemic medicine items were prescribed by general medical practitioners, followed by “other prescribers” and then by cardiologists. Only a small number of prescriptions claimed were prescribed by thoracic surgeons and even fewer by pharmacotherapists and pharmacists. Trade name products that were mostly prescribed were Lipitor and Adco-Simvastatin.
Of all the hipolipidaemic drugs utilised on the database, only three active ingredients (bezafibrate, simvastatin and pravastatin) had generic equivalents available at the time of the study. With total substitution (100%) of these three drugs with the average price of the available generic hipolipidaemic equivalents on the database, a cost saving of R1 744 462.27 or 1.63% (N = R106 943 348.53) was possible in 2005. In 2006, a total cost saving of R1 526 985.79 or 1.30% (N = R117 862 631.87) was calculated.
Conclusion: The study highlighted the most commonly prescribed hipolipidaemics within a sub-population of South African patients. The high average cost per prescription of hipolipidaemic drugs indicates that they are relatively expensive in comparison to other medications. Generic (and therapeutic) substitution should be investigated as potential cost-saving mechanisms in the private health care sector of South Africa. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2010.
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The treatment of paediatric asthma in the private health care sector of South Africa : a retrospective drug utilisation review / J. MoutonMouton, Jeanine January 2010 (has links)
Asthma is the most common chronic disease among children worldwide. The prescribing
patterns of the medication used to treat asthma in South Africa, as well as the prevalence of
paediatric asthma are of interest and need to be investigated.
A drug utilisation review was performed to determine the prevalence of asthma, and in
particular paediatric asthma in a section of the private health care sector of South Africa. The
prescribing patterns of asthma medication were investigated according to different
demographic factors, such as gender, geographical area and prescriber type. Data from a
medical claims database were extracted and processed to reveal the different prescribing
patterns from 1 January 2005 to 31 December 2008. Medication from the MIMS®
pharmacological groups 10.2 and 10.4 were used as a basis for asthma medication. Patients
had to use at least one medicine item from one of these groups to be included in the study.
The prevalence of asthma in the general population showed an increase from 2005 to 2008.
The prevalence of asthma as a part of the total database according to the number of patients
increased from 23.01% in 2005 (n=347342) to 24.72% in 2008 (n=240854), although the
number of patients on the total database decreased from 2005 to 2008. When investigating
the number of prescriptions that were dispensed during 2008, asthma prescriptions
comprised 7.16% (n=484983) of all prescriptions and the number of asthma medicine items
that were dispensed made up 3.72% (n=611139) of the total number of medicine items
dispensed in 2008.
Paediatric asthma was divided into two age groups for the purpose of this study namely, 0 -
4 years of age and older than 4 years, but younger or equal to 11 years of age ( >4 - 11
years), according to a previous study done by the National Heart Lung and Blood Institute
(NHLBI). The results from the data confirmed that the prevalence of asthma was higher in
the younger age group. The number of patients using asthma medication in the 0 - 4 years
age group comprised 44.40% (n=11306) of the total number of patients in this age group on
the database in 2008, compared to 32.84% (n=28347) in the >4 - 11 years age group.
Asthma was more common among male patients, whether they were included in the
paediatric groups or not. The geographical distribution of paediatric asthma seemed to be
connected to the provinces without coastlines and different mining facilities. The combination of asthma medication with antibiotics and systemic corticosteroids were investigated and it
was concluded that antibiotics that were used for respiratory tract infections were prescribed
the most frequently to asthma patients.
The refill–adherence rates of patients with asthma were not satisfactory when considering
that asthma is a chronic disease. The average adherence rate for all the asthma products
that were brought into account when calculating the refill–adherence rate was 60.95%. A rate
above 90% indicates optimal patient adherence.
In conclusion this study determined that asthma has a significant prevalence among children
in South Africa. The prescribing patterns for the different medication used in the treatment of
asthma were investigated and recommendations for further research in this field of study
were made. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.
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Prescribing patterns of methylphenidate and atomoxetine containing products in a section of the private health care sector of South Africa / Stephan RothmannRothmann, Stephan January 2009 (has links)
The general aim of this study was to investigate the prescribing patterns of products that contain methylphenidate or atomoxetine in a section of the private health care sector of South Africa. A quantitative, retrospective drug uitilisation review was performed according to data obtained from the database of a South African medicine claims pharmacy benefit management company's for three consecutive study years (Le. 2005 to 2007).
The results indicated that a total of 7,990 patients had been prescribed products that contained methylphenidate or atomoxetine in 2005. The total for 2006 was 8,575 and it decreased to a total of 7,828 in 2007. Of all the patients who received the mentioned products, the percentage for females increased from 27.75% (N = 7,990) in 2005 to 29.06% (N =7,828) in 2007. With regard to the same products the percentage for males decreased from 72.03% (N = 7,990) in 2005 to 70.89% (N = 7,828) in 2007. The ratio for the gender-related prescribing patterns of medicine items that contained methylphenidate or atomoxetine in this section of the private health care sector of South Africa was ± 2.55:1 for males to females in comparison with the international male:female ratio of 3:1.
According to the medicine claims on the database for 2005 the total number of prescriptions that indicated products containing methylphenidate or atomoxetine was calculated as 8,522, 798 (i.e. N = 8, 522,798) or as a percentage of 0.32% prescriptions. The percentage showed an increase to 0.41 % in 2007 (N = 8,015,538). Of all the medicine items containing methylphenidate or atomoxetine those products that contained atomoxetine represented 4.69% and those that contained methylphenidate represented 95.31%. In 2005 the average cost per prescription that indicated items containing methylphenidate or atomoxetine amounted to R318.29 ± R162.09. In 2007 the amount increased to R358.91 ± R208.10.
The percentage of children younger than five years of age, and who had been prescribed products containing methylphenidate or atomoxetine, increased from 0.91 % in 2005 (N = 7,990) to 1.11 % in 2007 (N =7,828). The percentage for children aged 5 to 12 years decreased from 53.62% in 2005 to 49.23% in 2007. For adolescents the percentage increased from 26.32% in 2005 to 27.35% in 2007. The same pattern repeated itself in the case of adults (age 18+ years).
Among the top trade name products prescribed were Ritalin LA 20mg®, Ritalin 20mg®, Concerta 36mg®, Ritalin LA 30mg® and Concerta 18mg®.
Possible drug-drug interactions were found between products containing methylphenidate or atomoxetine and products containing imipramine, amitriptyline and carbamazepine.
Findings indicated that the number of products containing methylphenidate or atomoxetine increased from 2005 to 2007, while also revealing that those products containing methylphenidate remained in the majority. The average costs of products containing methylphenidate or atomoxetine increased from 2005 to 2007. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2010.
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Prescribing patterns of angiotensin-converting enzyme inhibitors for the period 2001 until 2006 / Lourens Johannes RothmannRothmann, Lourens Johannes January 2007 (has links)
Thesis (M.Pharm. (Pharmacy Practice))---North-West University, Potchefstroom Campus, 2008.
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Prescribing patterns of asthma treatment in the private healthcare sector of South Africa / Johannes Marthinus de WetDe Wet, Johannes Marthinus January 2013 (has links)
Asthma is a chronic disease of the airways and affects many people regardless of their age,
gender, race and socioeconomic status. Since asthma is recognised as one of the major
causes of morbidity and mortality in people and especially in South Africa, the prescribing
patterns, prevalence and medication cost of asthma in South Africa are saliently important and
need to be investigated.
A non-experimental, quantitative retrospective drug utilisation review was conducted on
medicine claims data of a pharmaceutical benefit management company in a section of the
private health care sector of South Africa. The study period was divided into four annual
time periods (1 January 2008 to 31 December 2008, 1 January 2009 to 31 December 2009,
1 January 2010 to 31 December 2010 and 1 January 2011 to 31 December 2011). The
prescribing patterns and cost of asthma medication were investigated and stratified according
to province, age and gender. Patients were included if the prescriptions which were
provided by the health care practitioners matched the Chronic Disease List (CDL) of South
Africa and the International Classification of Disease (ICD-10) coding for asthma and chronic
obstructive pulmonary disease (COPD). Data analysis was conducted by means of the SAS
9.3® computer package. Asthma patients were divided according to different age groups
(there were five different age groups for this study), gender and geographical areas of South
Africa.
The study indicated a steady increase in the prevalence of asthma patients from 0.82% (n =
7949) in 2008 to 1.18% (n = 15 423) in 2009 and reached a minimum of 0.79% (n = 8554) in
2011. Analysis of the prevalence regarding geographical areas in South Africa suggested
that Gauteng had the highest number [n = 17 696, (0.85%)] of asthma patients throughout
the study period, followed by KwaZulu Natal [n = 8 628, 1.16%)] and the Western Cape [(n = 8513, 0.97%) (p < 0.05)]. The prevalence of asthma in female patients [0.89% (n = 26
588)] was higher than in their male counterparts [0.79% (n = 19 244)] (p > 0.05). The results
showed that asthma was not as common chronic disease in children. The total number of
asthma patients younger than 7 years represented 0.64% (n = 2 909). It was found that
patients over 65 years of age showed the highest prevalence of the five age groups [1.94%
(n = 13 403) (p < 0.05)].
The average number of asthma prescriptions per patient per year was 8.28 (95% CI, 8.16-
8.40) and 5.15 (95% CI, 5.06-5.23) in 2008 and 2011, respectively. The number of asthma
items per prescription varied from 1.55 (95% CI, 1.55-1.56) in 2008 to 1.40 (95% CI, 1.39-
1.40) in 2011.
Medication from the MIMS® pharmacological group (anti-asthmatics and bronchodilators)
was used to identify asthma medication. The top three asthma medication with the highest
prevalence in the study period were the anti-inflammatory inhaler of fluticasone (n = 39 721)
followed by the single item combination product of budesonide/ formoterol (n = 25 121) and
salbutamol (n = 24 296). The influence of COPD on asthma treatment and the costimplication
thereof were investigated. Medication from the MIMS® pharmacological group
(anti-asthmatics and bronchodilators) was used to identify COPD medication. This study
also showed that COPD had an influence in the economic burden of the South African
asthma population.
The cost of medication is responsible for the single largest direct cost involved in the
economic burden of asthma. This study showed that asthma represented 0.88% of the
direct medication cost in the study (excluding hospitalisation and indirect cost). The average
cost per prescription and average cost per asthma item both increased throughout the study
period.
The prescribing patterns for the different medication used in the treatment of asthma were
investigated and recommendations for further research in this field of study were made. / MPharm (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014
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