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PubMed2002

[Factors that affect the prescription of benzodiazepines and actions to improve their use: a Delphi study of primary care doctors].

OBJECTIVES: To identify the factors that affect the prescription of benzodiazepines and similar drugs and the actions that can be taken to reduce their prescription.Design. Consensus method. Delphi technique. SETTING: Four primary care areas in Asturias. Participants. 39 doctors from primary care teams agreed voluntarily to take part in the study, and 32 completed the study. They belonged to 20 health centres. METHOD: They were sent by mail three questionnaires one after the other. The second and third questionnaires were worked out on the basis of the analysis of the information from the replies to the preceding questionnaire. Those who did not send in a reply were reminded by phone. RESULTS: The 5 most influential factors in benzodiazepine prescription were agreed: reduction in the threshold of tolerance of emotional discomfort; increase of the prevalence of pathologies; lack of time in the consulting-room; social and economic conditioning factors; properties of the benzodiazepine family. The 5 most important actions that could reduce prescription of these drugs were agreed: general health education; reduction in case loads; making doctors more conscious of prescribing correctly; strengthening the social support network; doctors fomenting use of effective alternative treatments. CONCLUSIONS: The prescription of benzodiazepines and their analogues is a multi-factorial action with social and psychological roots. The action most voted on to reduce their prescription was general health education.

Adult↗
PubMed2004

[Prescription of drugs in family medicine: on the trail of efficiency].

OBJECTIVE: To analyse the effect of various factors on the efficiency of drug prescription by general practitioners (GPs). DESIGN: Descriptive, cross-sectional study. SETTING: Primary care in Murcia, Cartagena, and Lorca, in which 535 GPs work in the care of 921,281 people. Murcia Region (Spain).Participants. Prescriptions issued by the 288 GPs who were working constantly and continuously in May-June 1998 and who were away from work for no longer than 10% of the time (53.8%). MAIN MEASUREMENTS: We measured their efficiency with two general indicators--potential saving (PS) and prescription of generics (PG)--and 3 specific indicators: efficiency of prescription of omeprazole (EO), enalapril (EE), and ranitidine (ER). We analysed their relationship with structural-organisational factors and with the population attended, the doctor and his/her action. Bivariate and multivariate analyses (logistic regression) were used. RESULTS: There was an association with programmed consultation (PC); a weak inverse relationship with age of doctor, years qualified, pensioners allocated, case load and inter-consultations conducted; and a direct correlation with the length of the consultation. PG was related to rural environment, being non-permanent, specialist in family medicine, belonging to a primary care team. In the multivariate analysis PC was related to all the indicators: PS (OR=1.96), PG (OR=2.10), EO (OR=2.63), ER (OR=2.84), EE (OR=2.06); and the inter-consultations conducted with general efficiency of PS (OR=1.70), PG (OR=1.91). Rural environment was the worst for PS (OR=2.43). CONCLUSIONS: The main factors related to the efficiency of GPs prescription can be changed. The most important is the existence of PC. A lot of inter-consultations and working in a rural environment means worse general efficiency.

Adult↗
PubMed2003

Beta-blockers and angiotensin-converting enzyme inhibitors/receptor blockers prescriptions after hospital discharge for heart failure are associated with decreased mortality in Alberta, Canada.

OBJECTIVES: We sought to evaluate the common utilization of beta-blockers and angiotensin-converting enzyme (ACE) inhibitors or receptor blockers (RBs) in congestive heart failure (CHF). BACKGROUND: We assessed the association between prescriptions of beta-blockers and ACE inhibitors or RBs within three months after hospitalization and mortality for newly diagnosed CHF in Alberta, Canada seniors (age 65 years and older). METHODS: Administrative hospital discharge abstracts and drug data during October 1, 1994, to December 31, 1999, were analyzed. RESULTS: There were 11854 hospitalizations for newly diagnosed CHF. The use of beta-blockers within three months after hospitalization increased from 7.3% in 1994-1995 to 20.9% in 1999-2000. The use of ACE inhibitor or RBs within three months after hospitalization increased from 31.0% in 1994-1995 to 44.3% in 1999-2000. Adjusted one-year mortality was lower in seniors with prescriptions for beta-blockers (18.2%; 95% confidence interval [CI] 14.2 to 22.2), ACE inhibitors/RBs (22.3%; 95% CI 20.9 to 23.7), or both (16.6%; 95% CI 13.3 to 20.0), compared with those with no prescriptions (29.9%; 95% CI 28.8 to 31.0). Absolute adjusted risk reduction comparing no prescription with prescription of both beta-blockers or ACE inhibitors/RBs was 13.3% for a relative adjusted risk reduction of 44%. CONCLUSIONS: This study of incident CHF hospitalizations among seniors demonstrates an association between decreased mortality and the use of beta-blockers, ACE inhibitors/RBs, or combination of both. The effectiveness of beta-blockers and ACE inhibitors/RBs for CHF should be more broadly tested in clinical trials that recruit older patients and those with diastolic dysfunction.

Adrenergic beta-Antagonists↗
PubMed2001

How to organise antibiotic prescription.

In recent years, efforts have been made in hospitals to improve antibiotic prescription. Most universities organise courses on the subject, which lead to a local university diploma. However, possessing such a diploma does not give entitlement to prescribe. In fact, most doctors prescribe antibiotics and such courses are only of interest to volunteer physicians. While some are very careful, the majority prescribe the drugs as they are rarely toxic. Others are refractory to any information and particularly to any training. Two methods are typically proposed to reduce unjustified prescription. As a result of imposed restrictions, only trained doctors having met the training standards are allowed to prescribe and have to keep to a limited budget. The persuasive method, on the other hand, opens the way for a wide scope of training courses, which are provided by industry; some are said to be biased as they encourage prescription and the risk of selecting resistant mutant bacteria is scarcely documented. This method does not always coincide with the training curricula. The industry is torn between declared objectives such as judicious drug use and prevailing commercial aims. As a result, prescription is not restrained by any objective limit. It should be noted that prescription varies greatly from one hospital to another and within a given hospital between one department and another. Certain departments prescribe much more than others and these (emergency, medical and surgical intensive care, respiratory disease) should be targeted first.

Anti-Bacterial Agents↗
PubMedDate not supplied

Evaluating prescriptions for the elderly: drug/age criteria as a tool to help community pharmacists.

OBJECTIVES: To use drug/age criteria to determine (1) the prevalence of dispensing of drugs potentially inappropriate for use in elderly patients; (2) the dispensing rate of individual drugs considered potentially inappropriate for use in elderly patients; (3) the association between selected patient characteristics and the prevalence of potentially inappropriate drug dispensing. DESIGN, SETTING, PARTICIPANTS: A secondary database of 6,380 new prescription orders dispensed to patients of all ages in ambulatory pharmacies in a mid-western state was used retrospectively for the analysis. A total of 1,530 (23.9%) of the new prescription orders were dispensed to 1,185 elderly patients. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Name, strength, and daily dose of each drug dispensed were compared with drug/age criteria to determine whether a dispensed drug was inappropriate for use in elderly patients. The association of the rate of dispensing of potentially inappropriate drugs with characteristics of the elderly patients, including age, sex, race, number of comorbidities, and prescription drug insurance coverage type, was determined. RESULTS: A total of 170 patients (14.3%) were dispensed potentially inappropriate medications. The three most common medications were propoxyphene and propoxyphene combinations, prescription and nonprescription antihistamines, and digoxin at doses > 0.125 mg/day. There was no statistically significant association between inappropriate drug dispensing and patient age, sex, race, number of comorbidities, and prescription drug insurance coverage type. CONCLUSION: Pharmacists can use drug/age criteria as a tool for an initial check to assess the appropriateness of drugs used by the elderly. Elderly patients appear equally at risk of using potentially inappropriate medications regardless of demographic, disease, or insurance characteristics.

Age Factors↗
PubMed2001

[Qualitative assessment of labile blood product prescription in Le Havre Hospital].

This retrospective study assessed the conformity of prescriptions of labile blood products as well as the respect of legal requirements and recommendations concerning red blood cells specifications. This study was carried out in two phases one year apart, so as to be able to compare between them. It consisted in an analysis of the administrative and medical information present on the prescription forms and of the discrepancies between the prescribed product and that which was dispensed. Quality of prescriptions was overall better, but some points needed further improvement. The data moreover showed that some prescriptions of phenotyped and cross-matched red blood cells were incomplete. This did not improve over time. Out of 1000 prescriptions for red blood cells, 216 were altered by the transfusion service dispensing unit. A closer look at these changes showed that 49% were justified by statutory requirements or by local protocols. The discrepancies observed between the prescribed product and that which was dispensed were partly due to a poor understanding by the prescribers of statutory requirements. However they are mostly related to particular circumstances, such as emergencies. Furthermore, the prescribers expected the transfusion center to adapt the product in terms of the clinical context.

Documentation↗
PubMed1999

Prescription data as a tool in pharmacotherapy audit (I). General considerations.

This article discusses how prescription data that are available from pharmacies can be used as a tool to support the improvement of prescribing behaviour. For the optimal use of prescription data in pharmacotherapeutic audit, the specific aim of the audit meeting must be clear. Next, appropriate measures (quality of drug choice, volume, cost) have to be selected for the presentation and discussion of prescribing. For several aims of audit meetings, suggestions for adequate measures are given. For each stage of behavioural change the article describes why and how prescription data can provide a useful contribution. Finally, recommendations are given regarding prerequisites for the optimal use of prescription data. Important factors are that the prescription data should sufficiently cover the physicians' patient population, information regarding the extent of repeat prescribing is needed, and the prescribing of drugs with multiple indications can cause difficulties with the interpretation of the graphs. With this information in mind, feedback on prescribing can be tailored to the audit groups' needs and targeted to the intervention that is pursued.

Attitude of Health Personnel↗
PubMed2001

Determinants of pharmacists' interventions linked to prescription processing.

AIM OF STUDY: The role of pharmacists in today's healthcare is changing rapidly. As they are close to the prescribing process, pharmacists are in the position to identify and adjust prescribing errors before dispensing. The objective of this study was to identify relevant determinants of interventions directly linked to prescription processing in community pharmacy. METHODS: As part of a yearly continuing education programme, all community pharmacies in the region of 'Zealand' (N = 23) in the south-west of The Netherlands kept detailed records of all interventions directly linked to prescription processing during one week in May 1998. For every patient involved in an intervention, a control-patient was matched on pharmacy practice, date, gender and age. RESULTS: A total of 39,357 prescriptions were evaluated by the 23 pharmacies during the one-week intervention programme. Out of these, one out of 10 resulted into an intervention. Being a first prescription in a new treatment episode was found to be a significant determinant (OR 1.75, 95 CI% 1.18-2.33). Variables reflecting drug therapy complexity (> 3 prescribers, > 15 prescriptions in 3 months before, > 3 different medications) showed all ORs higher than 1.00, but not significant. When looking at the individual drug categories, anti-infectives, respiratory drugs and cardiovascular medicines came out as important drug classes for intervention risk. We could not find any association between the number of signals per pharmacy and the number of interventions. CONCLUSION: The 'whistle-blower' model of pharmacy based interventions is a valid one but needs a targeted and integral way of implemented thinking and use of information technology. In such an environment, interventions are a logical step of in-process quality control in the drug usage system.

Aged↗
PubMed2001

Assessing NSAID prescription use as a predisposing factor for gastroesophageal reflux disease in a Medicaid population.

PURPOSE: The purpose of the study was to determine the incidence of GERD associated with prescription NSAID consumption. METHODS: All Georgia Medicaid patients > 25 years of age and continuously eligible for 1996, 1997, and 1998 were included in the study. Patients were excluded if they received a GERD diagnoses during 1996 and 1997. Patients were observed in 1998 and classified into GERD and control cohorts. Comorbidities, demographics, and NSAID prescription consumption were retained and modeled with logistic regression. RESULTS: The absolute risk of developing GERD without previous NSAID consumption was 0.38. The absolute risk of developing GERD for those patients who consumed one or more NSAID prescriptions during 1996 and 1997 was 0.80. Thus, the relative risk of GERD for NSAID patients was 2.11. GERD was significantly associated with one or more NSAID prescriptions (OR = 1.82), age (OR = 1.05 for 5 year range), gender (OR = 1.31 for females), asthma (OR = 3.24), obesity (OR = 2.77), hiatal hernia (OR = 4.17), tobacco use (OR = 2.56), and alcohol (OR = 1.83). The initial NSAID prescription was responsible for the greatest marginal increase in GERD. CONCLUSIONS: Our study suggests that NSAIDs are associated with GERD especially for females, alcohol and tobacco users, and patients with asthma, hiatal hernia, or obesity.

Adult↗
PubMed2003

Repeated nitrate prescriptions as a potential marker for angina pectoris. A comparison with medical information from the Rotterdam Study.

OBJECTIVE: The objective of this study was to determine whether pharmacy records of nitrate prescriptions could be used as a marker of angina pectoris. METHOD: This study was conducted within the Rotterdam Study, a prospective follow-up study which started in 1991 and included 7983 elderly subjects. During follow-up, 1601 subjects filled a first prescription for a nitrate and later filled at least one other prescription for nitrates according to pharmacy records. After excluding subjects who started using nitrates in 1991 and who had less than one year of medication history, we took a random sample of 78 subjects (10%). We studied discharge and outpatient cardiologist letters and files from general practitioners for additional information on angina pectoris in these subjects, and allocated patients to one of three categories according to the possibility of the initial diagnosis of angina being correct. RESULTS: From the random sample of 78, additional information was available on 75 subjects. Definite angina pectoris was present in 33, probable angina pectoris in 18, and possible angina pectoris in 19 subjects. Five subjects had no angina pectoris. Therefore, 93% had at least a possible diagnosis while 68% had at least a probable diagnosis of angina pectoris. The positive predictive value of 2 nitrate prescriptions of which at least one was for rescue therapy was 94%. CONCLUSIONS: We conclude that the use of more than one nitrate prescription can be used as a marker for angina pectoris. This marker may be useful in epidemiological studies.

Aged↗
PubMed2005

Trends in obesity and overweight-related office visits and drug prescriptions in Canada, 1998 to 2004.

OBJECTIVE: Obesity and overweight are affecting increasing numbers of Canadians and have received considerable amounts of medical, governmental, and media attention in recent years. This study sought to determine whether this rise in prevalence and awareness has resulted in an increased frequency of obesity and overweight-related office visits or antiobesity drug prescriptions over the past 5 years. RESEARCH METHODS AND PROCEDURES: Data from IMS Health Canada were used to derive nationally representative estimates of trends in the annual number of obesity and overweight-related office visits (1999 to 2003) and the quarterly prescription volume of antiobesity drugs (July 1998 to March 2003) in Canada. RESULTS: The number of obesity and overweight-related office visits increased by 20% between 1999 and 2000 but then remained constant. The number of antiobesity drug prescriptions peaked in 2001 and has since declined, with parallel trends being observed for all individual agents. In contrast, the overall frequency of office visits and drug prescriptions in Canada (for any reason) progressively increased over the study period. Middle-aged women were the most common type of patient to seek physician advice regarding obesity, and general practitioners were the most common type of physician visited. DISCUSSION: Increases in the prevalence and awareness of obesity have not resulted in major increases in office visits or drug prescriptions for this condition over the past 5 years. A number of patient, physician, and drug-related factors may explain these results, which are likely a reflection primarily of the current lack of effective weight loss strategies for obese individuals.

Adult↗
PubMedDate not supplied

Family reports of cancer pain, pain relief, and prescription access.

PURPOSE: The authors 1) describe family caregiver reports of degree of pain, pain relief, and prescription access in persons with advanced cancer during the last 4 weeks of life and 2) test for differences according to geographic location and care setting. DESCRIPTION OF STUDY: A randomized, stratified sample of 375 caregivers was produced from a list of all state residents who died of cancer in 1994. Written informed consent was received from 170 family caregivers (46%) who were then interviewed by telephone. Caregiver responses regarding pain intensity, pain relief, prescription access, and care setting were analyzed. RESULTS: Eighty-six percent (n = 147) of caregivers reported that pain was a problem, and 61% (n = 103) recalled a great deal to quite a bit of pain compared with 25% (n = 44) who recalled some or little pain. The mean degree of pain was 2.23 (SD +/- 1.32) on a scale of 1 (a great deal) to 5 (no pain). Of 140 caregivers reporting pain relief data, 46% (n = 64) reported that interventions either stopped the pain or that pain became much better, whereas 54% (n = 76) reported that interventions made the pain a little better, had no effect, or made it worse. The overall mean of pain relief was 2.62 (SD +/-.87) on a scale of 1 (usually stopped the pain) to 5 (made it worse). Greater degrees of pain were associated with reports of less pain relief (r = -19; P =.02). No differences in pain or pain relief were found across county type or patient care setting. Caregivers in the institution-only group (n = 18) recalled lower degrees of pain and the home-only group (n = 61) reported the most pain relief. Many in this latter group were served by hospice and home health nurses, and only 4% of the entire sample were served by physicians alone. Notably, 12% (n = 21) of the sample reported problems filling prescriptions. Of these, half had difficulty obtaining medicine because it was "not available." A total of 48 problems with prescription access were found that were distributed evenly across county types and patient care settings. CLINICAL IMPLICATIONS: Findings suggest that caregiver reports about the degree of pain or the effectiveness of pain interventions do not vary by residence or care setting at the end of life. Pain relief is moderate at best. Health professionals in all patient care settings should routinely address the issue of obtaining and paying for prescriptions, and local cancer pain task forces should be formed to advocate for better pain relief. An additional solution is to equip families with problem-solving skills specific to cancer pain.

Adult↗
PubMed2000

Assessment of antibiotic prescription in acute respiratory infections in adults. The Spanish Study Group on Antibiotic Treatments.

OBJECTIVE: This study aims to ascertain the variability in the use of antibiotics for the treatment of acute respiratoryinfections in several hospital emergency services in Spain, as well as the appropriateness of antibiotics prescription through evaluation by a panel of experts using available scientific evidence. METHOD: A cross-sectional study was carried out in the emergency services of 10 hospitals in different Spanish regions. We chose patients diagnosed as having acute respiratory infection, aged over 14 years. Among the collected variables were: type of respiratory infection, antibiotic prescription, comorbidity, qualification of the prescribing doctor and hospital admission. The consensus conference held by a panel of experts established first choice treatment and the alternative and inappropriate use for each respiratory infection, based on the available scientific evidence. All the observed prescriptions in our study were classified according to this pattern. RESULTS: A sample of 2899 acute respiratory infections was studied (5.5% of all emergencies). Antibacterial agent treatment was prescribed in 82.6% of these, varying according to the infection between 98.5% of pneumonias and 49% of croup-influenza-common cold. The most commonly used antibiotics were amoxicillin-clavulanate and cefuroxime. The global percentage of inappropriate prescription was 40.5% (95% CI; 35.4-45.5). The prescriptions were inappropriate in 16.9% of cases of pharyngotonsillitis, 17.8% of chronic bronchitis, 26.9% of acute bronchitis, 29.3% of pneumonias, 30.8% of otitis and sinusitis and in 70.8% of croup, flu, common cold and non-specified infections. Significant variability among participating centres was observed, both in choice of antibiotics and in their degree of appropriateness. CONCLUSIONS: There is excessive use of antimicrobial drugs in acute respiratory infections, and the majority are used for viral infections. There is indiscriminate use of broad spectrum antibiotics, which are valid in some infections but clearly inappropriate in others. Similarly, there are important differences in the choice of antibiotics and their degree of appropriateness among hospitals.

Acute Disease↗
PubMed2005

Prescription rates and diagnostic patterns are stable: a comparison of high-, medium- and low-prescribing primary care physicians treating community-acquired respiratory tract infections.

The objective was to study prescription practices of primary care physicians in prescribing antibiotics for community-acquired respiratory tract infections. Design was time series analysis and cross-sectional survey. The setting was 30 community primary health care centres. A case report form was completed for 3478 patient consultations treated by 198 office-based primary care physicians. Main outcome measures were: classification of diagnoses of respiratory tract infections made by each physician; number of antibiotic prescriptions related to these diagnoses; each physician's mean weekly number of antibiotic prescriptions during 6 months before and after the survey. Patients' risk (odds ratio: OR) to receive an antibiotic prescription from the high and medium prescribers was 5.81 (95% confidence interval [CI] 4.85-6.96) and 2.41 (95% CI 2.04-2.86), compared to low prescribers. High and medium prescribers made more diagnoses of otitis media (OR 2.07, 95% CI 1.70-2.53 and 1.85, 95% CI 1.51-2.26, respectively) and fewer diagnoses of unspecified upper respiratory tract infection (OR 0.32, 95% CI 0.26-0.38 and 0.57, 95% CI 0.48-0.68, respectively) than low prescribers. The rank of the prescription rate of high, medium and low prescriber groups remained the same for all diagnoses except pneumonia. In addition, the annual rank between high, medium and low prescriber groups remained stable; high group prescribed more antibiotics during the year than medium group, which prescribed more than low prescriber group.

Anti-Bacterial Agents↗
PubMed1998

Prescribing systemic antibiotics in general practice. A report from the Møre & Romsdal Prescription Study.

OBJECTIVE: To describe general practitioners' (GPs) prescribing patterns for antibiotics and to compare them with therapeutic guidelines. DESIGN: Cross-sectional, observational study. SETTING: In the Norwegian county Møre & Romsdal the GPs recorded all contacts with patients and prescriptions during two months. SUBJECTS: 69,843 contacts with 56,758 prescriptions, of which 7905 were for systemic antibiotics. MAIN OUTCOME MEASURES: Prescriptions in relation to diagnosis, kind of consultation, and patients' age and sex. RESULTS: 61% of all antibiotic prescriptions were for females, 26% were issued during indirect contacts, and 14% were repeat prescriptions. Phenoxymethylpenicillin was prescribed most frequently (32%), followed by co-trimoxazole (19%), tetracyclines (18%), erythromycin (16%), and penicillins with extended spectrum (6%). Urinary tract infection was the most frequent diagnosis for antibiotic prescribing (24%), followed by acute bronchitis (13%), ear infections (9%), upper respiratory tract infections (8%), and acute tonsillitis (8.2%). A regression analysis showed that first-time consultations for tonsillitis and otitis, but not for acute bronchitis and pneumonia, patient age 13-64 years, female physician, urban practice location, and a fixed. GP salary were associated with the prescribing of phenoxymethylpenicillin in contrast to other antibiotics. CONCLUSION: Antibiotics are often prescribed for viral infections (e.g., acute bronchitis). Broad spectrum antibiotics are often prescribed for diagnoses where penicillin is recommended as first choice. The issue of antibiotic misuse should be addressed more explicitly in general practice.

Adolescent↗
PubMed2004

Prosthetic prescription in the Netherlands: an interview with clinical experts.

In the process of guideline development for prosthetic prescription in the Netherlands the authors made a study of the daily clinical practice of lower limb prosthetics. Besides the evidence-based knowledge from literature the more implicit knowledge from clinical experts is of importance for guideline development. In order to obtain this information the authors performed both an observational study of clinical practice and an interview study with 11 clinical experts from the three key disciplines in this field. The latter study is presented here as a descriptive and qualitative study. The combination of the opinions on prescription criteria given in these semi-structured interviews appeared divided with regard to various options in the prescription of a lower limb prosthesis. However, the implicit knowledge is considered by the authors of importance for the consensus procedure on guideline development. Prosthetic prescription criteria seem to be based on local experience and partly on assumptions. A consensus procedure can lead to improvement of the knowledge about prosthetic prescription.

Artificial Limbs↗
PubMed2001

Agreement between general practice prescription data and self-reported use of hormone replacement therapy and treatment for various illnesses.

BACKGROUND: Epidemiological studies of the effects of hormone replacement therapy (HRT) often rely on exposure data and information on past health from self-administered questionnaires. The accuracy with which women report current use of HRT and the specific preparation in use is not known. This study aims to compare aspects of self-reported use of HRT and treatment for various conditions with data from general practice prescription records. METHODS: Reported questionnaire data on use of HRT were compared with those on the general practice prescription record for 570 women participating in the Million Women Study from two general practices in the UK. RESULTS: There was excellent agreement between data from the self-administered questionnaire and the prescription record: 96% agreement (kappa = 0.91) for current use of HRT, 95% agreement (kappa = 0.90) for any use of HRT during the period covered by the prescription record, and 97% agreement (kappa = 0.95) among current users for whether the HRT preparation contained oestrogen alone, combined oestrogen/progestogen, or some other constituents. Among former HRT users who provided questionnaire information on the preparation they used most recently, there was 69% agreement on the proprietary preparation used and 97% agreement (kappa = 0.93) on the hormonal constituents used. Agreement between reported treatment for various conditions and the presence of a prescription appropriate for that condition ranged from 89-99% (kappa 0.53-0.92), and was highest for thyroid disease and asthma. CONCLUSION: Important aspects of use of HRT, such as type of preparation currently being used, are reported very reliably by women completing a self-administered questionnaire.

Drug Prescriptions↗
PubMed2000

The use of abusable prescription drugs: the role of gender.

It is well documented that women face greater medical exposure to psychotropic drugs than do men, but little research examines whether women also have increased use of prescription drugs with abuse potential. The objectives were to examine gender differences in the use of abusable prescription drugs and to assess how use varies by gender and if patterns of use vary across therapeutic drug classes. With data from the 1987 National Medical Expenditures Survey (NMES), logistic regression analysis is used to model the influence of gender and other sociodemographic and diagnostic variables on the probability of drug use. Women are 48% more likely than men to use any abusable prescription drug, controlling for demographics, health status, economic status, and diagnosis. Additional analyses reveal that being female is a statistically significant predictor of anxiolytic and narcotic analgesic use but not of sedative-hypnotic or stimulant use. Marital status, age, urbanicity, employment status, and having a regular source of care explain gender differences in the use of abusable prescription drugs. Both healthcare and substance abuse treatment providers should be cognizant that women may have greater exposure to these potent prescription medicines.

Adolescent↗