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PubMed1994

Drug utilization review of oral forms of benzodiazepines in a Belgian 635-bed teaching hospital.

A retrospective study based on 4,307 drug patient records was designed to establish a chart of the consumption of benzodiazepines administered orally in a 635-bed teaching hospital, and to determine the influence of patient-related parameters (age, sex) and hospital-related parameters (type of services, prescription habits, etc.) on benzodiazepine utilization. Another objective was to evaluate to which extent benzodiazepine consumption can be induced by hospitalization. A minor but statistically significant difference (p < 0.05) was observed between the proportion of male (42.7%) and female (46.5%) users. Besides, when evaluating the consumption in number of defined daily doses per 100 beddays, there was little difference between the consumption of male (51.2 defined daily doses per 100 beddays) and female (52.8 defined daily doses per 100 beddays) patients. A significant influence of age was also observed with an increase of benzodiazepine use for patients aged from 15-20 to 40-45, followed by a progressive decrease for higher ages. With hypnotics, no peak of consumption related to age was observed but an increase of consumption from age 15-20 to 30-35. For higher ages the consumption of hypnotics was nearly stable or rising slowly. High variations in benzodiazepine utilization were recorded between hospital wards (median: 50.77 defined daily doses per 100 beddays, range 0.23-263.9). Finally, it was found that 6.8% of patients with a benzodiazepine treatment initiated during hospitalization may be considered as potential benzodiazepine consumers after discharge.

Administration, Oral↗
PubMed2003

Drug utilization review of celecoxib in Ontario.

Cyclooxygenase (COX)-2-specific inhibitors were developed to circumvent the gastrointestinal toxicity of non-specific non-steroidal anti-inflammatory drugs while maintaining efficacy. However, the higher acquisition cost of COX-2-specific inhibitors has resulted in the implementation of a programme for cost containment in the Ontario public drug program. This programme consists of limited use (LU) criteria that need to be met for drug reimbursement of patients with osteoarthritis (OA) or rheumatoid arthritis (RA). Determining the proportion of patients eligible for reimbursement for celecoxib according to the LU criteria (based on prior treatment failure and the presence or history of serious ulcer-related gastrointestinal complications) can provide an indication of the extent of adherence to suggested guidelines. Using a patient-based survey and an analysis of the Ontario Drug Benefit Program database, the proportion of patients prescribed celecoxib who met rigorous or pragmatic definitions of the LU criteria was determined. The extent of coprescription of gastroprotective agents among patients taking celecoxib was also determined. Using the pragmatic definition, the majority of patients in the patient-based survey (53% for OA and 81% for RA) met the LU criteria. Similarly, in the database analysis, the majority of patients (76% for OA and 78% for RA) met the LU criteria. These data suggest that physician prescribing of celecoxib is consistent with the LU criteria. Concomitant prescription of gastroprotective agents in patients taking celecoxib was approximately 40%. It is recommended that further investigations be performed to determine the long-term impact of LU criteria on clinical and economic outcomes, since these criteria may also serve to restrict use in patients who may benefit from taking COX-2-specific inhibitors.

Aged↗