Regional variation and adherence to guidelines for drug treatment of asthma
Regional variation and adherence to guidelines for drug treatment of asthma
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DOI：
10.1007/s00228-009-0731-7
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发表时间：
2010-02-01
影响因子：
2.9
通讯作者：
Jonsson, Eva Wikstrom
中科院分区：
文献类型：
--
作者：
Arnlind, Marianne Heibert;Wettermark, Bjorn;Jonsson, Eva Wikstrom
目的描述瑞典平喘药的使用情况，并探讨各地区在平喘药使用和合理用药指南依从性方面的差异及其基本原理。方法从瑞典国家处方药登记处获取2005年7月至2008年12月瑞典18 ~ 44岁公民的平喘药数据。期间流行率是通过分析使用者/1000居民的数量来确定的，发病率是通过分析18个月戒毒期后新使用者的数量来确定的。三个与药物相关的指标被用来评估对指南的遵守情况。所有指标均按性别和地区进行分析。结果2007年共有16.1万例患者使用了抗哮喘药物，男性患病率为4%，女性患病率为6%；发病率分别为2%和3%。不同地区的总药物使用情况和对指南的遵守情况各不相同。抗哮喘药物的总药物支出为2.58亿瑞典克朗（2800万欧元），固定剂量组合占支出的46%。分配处方预算的模式或明确的药物和治疗委员会建议与遵守指南之间没有关系。结论瑞典各地区在平喘药物的使用上存在较大的地区差异，在指南的依从性方面有很大的改进空间。未来可能需要新的方法来影响医生的行为，以提高依从性。
Aims To describe the utilization of antiasthmatic drugs in Sweden and to explore regional variations in drug utilization and adherence to guidelines for rational drug prescribing of antiasthmatics and their rationale.Methods Data on antiasthmatic drugs dispensed between July 2005 and December 2008 to all Swedish citizens aged between 18 and 44 years were obtained from the Swedish National Prescribed Drug Register. The period prevalence was determined by analyzing the number of users/1000 inhabitants, and the incidence by analyzing the number of new users after an 18-month drug-free wash-out period. Three drug-related indicators were used to assess the adherence to guidelines. All measures were analyzed by gender and region.Results A total of 161,000 patients were dispensed antiasthmatics in 2007, corresponding to a prevalence of 4 and 6% among men and women, respectively; the incidence rates were 2 and 3%, respectively. The total drug utilization and adherence to guidelines varied between regions. The total drug expenditures of antiastmatics were 258 million SEK (28 million euro), with fixed dose combinations accounting for 46% of the expenditure. No relation was found between models for allocating prescribing budgets or clear Drug and Therapeutics Committee recommendations and adherence to guidelines.Conclusion There are large regional variations in the utilization of antiasthmatics between Swedish regions, with substantial room for improvement in the adherence to guidelines. New methods of influencing physician behavior may be needed in the future to enhance adherence.