Current Prescription-medicine News Results

The prevalence of herbs use in conjunction with conventional medicines in Jamaica.

Complement Ther Med. 2010 Feb; 18(1): 13-20
Delgoda R, Younger N, Barrett C, Braithwaite J, Davis D

Due to the global rise in the popularity of herbal medicines, adversities resulting from concomitant use of both prescription drugs and herbs are becoming an increasingly important public health issue. OBJECTIVES: To estimate the prevalence of the use of herbal medicines among persons on prescription medicines in Jamaica. Findings are thought to aid in estimates of the risk of adversities from drug-herb interactions through laboratory investigations and to provide awareness among policy makers responsible for the design of appropriate pharmacovigilance systems in the country. METHODS: A survey was conducted in eighteen pharmacies throughout Jamaica and patients or parents/carers of children who were on at least one prescription medicine were administered a structured questionnaire by trained interviewers. RESULTS: Of 399 persons invited to participate in the study 365 (91.5% response rate) agreed to do so and were included in the study. This study population consisted of 306 adults and 60 children and of that 243 adults (80.6%) and 45 children (75.6%) engaged in the concomitant use of herbs and drugs. Patients with a variety of disease conditions, in both rural and urban environs engaged in concomitant herb-drug use. Persons with higher salary (P<0.1) and those with health insurance (P<0.02) tended to have a lower prevalence of herb-drug concomitant use. Among persons indicating such practices the most commonly cited reason for concurrent use of prescription medicine and herbal preparations was the belief that there was no harm in taking both (269, 94.0%) followed by the belief that the prescription medicine alone was not adequate cure (211, 71%). Only 55 (18%) respondents who practised such co-medication indicated that their doctors knew of their use of herbal preparations. CONCLUSION: There is a high prevalence of herb-drug concomitant use in Jamaica, and an awareness within the medical community and those monitoring adversities would serve well to mitigate risks from potential drug-herb interactions.

Safety of non-prescription medicines: knowledge and attitudes of Italian pharmacy customers.

Pharm World Sci. 2010 Feb; 32(1): 97-102
Cuzzolin L, Benoni G

OBJECTIVE: A survey was designed to investigate customers attitudes and knowledge toward non-prescription medicines taken on a self-medication basis but not devoid of risks. SETTING: Community pharmacies in Italy. METHOD: Forty-four pharmacies participated in the project. On the basis of an anonymous questionnaire, face-to-face interviews were made to customers buying a non-prescription medicine over a 2-month period. The questionnaire included information about socio-demographic characteristics of the interviewed subjects and 18 items designed to elicit information about the kind of medicine purchased and reason of use, general product knowledge in relation to quality and risks, attitudes toward this kind of drugs, concurrent prescription drug use and the quality of relationship with the pharmacist. RESULTS: During the study period, 613 interviews were collected. The most frequently non-prescription medicines purchased by customers were non-steroidal anti-inflammatory drugs, paracetamol and medicines for gastrointestinal problems. The most of interviewees referred to read carefully the package inserts or to ask information to pharmacists. Moreover, they reported to consider non-prescription medicines easy to manage and to be used only for minor ailments and for short periods. 55.3% of customers reported to have been taking at least a prescription drug, mostly antihypertensives or other cardiovascular medicines, in association with non-prescription medicines. In this situation, interviewees often did not inform pharmacists about chronic therapies. CONCLUSION: Our interviews demonstrate that, in general, Italian customers have a cautious approach toward non-prescription medicines and are informed on their use. However, in case of a long-term use, interviewees underestimate risks related to possible physiological/pathological changes in their organism or to interactions with other drugs.

Association of hypertension treatment and control with all-cause and cardiovascular disease mortality among US adults with hypertension.

Am J Hypertens. 2010 Jan; 23(1): 38-45
Gu Q, Dillon CF, Burt VL, Gillum RF

BACKGROUND: Clinical trials have provided convincing evidence that blood pressure (BP) lowering treatment reduces the risk of cardiovascular disease (CVD) and total mortality. The objective of this study was to examine the association of hypertension treatment, control, and BP indexes with all-cause and cardiovascular mortality among US adults with hypertension. METHODS: Persons aged > or =18 years from the Third National Health and Nutrition Examination Survey (NHANES III) were identified as hypertensives based on a BP > or =140/90 mm Hg or current treatment for hypertension. Vital status in 2006 was ascertained by passive follow-up using the National Death Index. Cox regression models were used to assess correlates of survival. RESULTS: At baseline, 52% of hypertensive adults reported currently taking prescription medicine for high BP and 38% of treated persons had BP controlled. Compared to treated controlled hypertensives, treated uncontrolled hypertensives had a 1.57-fold (95% confidence interval (CI) 1.28-1.91) and 1.74-fold (95% CI 1.36-2.22) risk of all-cause and cardiovascular mortality; untreated hypertensives had a 1.34-fold (95% CI 1.12-1.62) and 1.37-fold (95% CI 1.04-1.81) risk of all-cause and cardiovascular mortality, respectively. The association persisted after further excluding persons with pre-existing hypertension comorbidities. Mortality risk was linearly increased with systolic BP (SBP), pulse pressure (PP), and mean arterial pressure (MBP), whereas diastolic BP (DBP) was not a significant predictor of cardiovascular mortality overall. No significant associations were observed between drug classes and mortality risk. CONCLUSIONS: This study indicates that uncontrolled and untreated hypertension was associated with increased risk of total and cardiovascular mortality among the general hypertensive population.

Medication effects on midtrimester maternal serum screening.

Am J Obstet Gynecol. 2009 Dec; 201(6): 622.e1-5
Pekarek DM, Chapman VR, Neely CL, Ramsey PS, Biggio JR

OBJECTIVE: To determine whether medication classes are associated with alterations in concentrations of Quad screen analytes or the screen-positive rate. STUDY DESIGN: We conducted a retrospective cohort study of women with singleton gestations who received prenatal care and had a Quad screen performed in the University of Alabama at Birmingham system. Information on prescription medications was abstracted. Mean multiples of the medians for each analyte (alpha-fetoprotein, estriol, human chorionic gonadotropin, and inhibin A) and overall screening results were compared between those taking the class of medication and controls not taking any medications. RESULTS: There were 6206 women evaluated; 1337 took at least 1 prescription medicine and 4869 were controls. Mean analyte multiples of the medians were significantly different in women taking some medications compared with controls. Women taking certain medications had an increased screen-positive rate. CONCLUSION: Medications taken around the time of maternal serum screening are associated with alterations in individual analyte multiples of the medians, as well as the screen-positive rates.

Antacid use and reduced bioavailability of oral drugs. Case studies, overview and perspectives.

Arzneimittelforschung. 2009; 59(7): 327-34
Srinivas NR

A close scrutiny of deployment of the present day home medicines has shown increased indulgence of antacids as a household remedy. While such household interventions are considered innocuous, it could trigger potential drug-drug interaction(s), if the subject is taking other prescription medicine(s). Examination of the literature indicated that co-administration of antacids may have the potential to cause therapy failures due to reduced oral bioavailability of several drugs. Additionally, fortified foods and beverages with mineral supplement may also have the potential to reduce the bioavailability of oral drugs. On the basis of this review a number of drugs displayed reduced oral bioavailability in the presence of antacids. However, almost one third of the reviewed drugs showed a drastic bioavailability reduction (< 50%) warranting total avoidance of antacid ingestion in such drug uses. If antacid use is warranted, it needs to be carefully monitored in relation to the administration of the drug (either pre or post drug administration). It appeared that a safe window for antacid administration could be established especially for drugs that display moderate reduction of oral bioavailability. While possible mechanisms explaining the purported antacid-drug interaction are covered, additional perspectives with regard to assessment protocols for antacid-drug interaction are discussed.

[Herpes zoster incidence in persons above 50 years of age]

Ugeskr Laeger. 2009 Jun 22; 171(26): 2194-7
Østergaard K, Damgaard M, Kristiansen TB, Kristensen TB, Madsen KG

INTRODUCTION: Following the development of herpes zoster vaccines and the potential socio-economic benefits hereof, it is relevant to conduct a study concerning epidemiological aspects of the disease based on a Danish population. MATERIAL AND METHODS: Structured telephone interviews with 1207 persons above 50 years of age were conducted in order to determine the cumulated incidence proportion of herpes zoster in the age groups 50-66 years, 66-70 years and 71+. RESULTS: The cumulated incidence proportion of herpes zoster was 8.9%, 12.5%, 16.0% in the age groups 50-65 years, 65-70 years and 71+, respectively. Herpes zoster was positively associated with female sex, hypertension, hypercholesterolemia and prescription medicine; however, only the former remained significant after test in a multiple logistic regression model. CONCLUSION: Herpes zoster is common among persons who are more than 50 years old and most frequent among women.

The impact of information on patient preferences in different delivery patterns: a contingent valuation study of prescription versus OTC drugs.

Health Policy. 2009 Dec; 93(2-3): 102-10
Lamiraud K, von Bremen K, Donaldson C

OBJECTIVES: Our analysis assessed the impact of information on patients' preferences in prescription versus over-the-counter (OTC) delivery systems. METHODS: A contingent valuation (CV) study was implemented, randomly assigning 534 lay people into the receipt of limited or extended information concerning new influenza drugs. In each information arm, people answered two questions: the first asked about willingness to pay (WTP) for the new prescription drug; the second asked about WTP for the same drug sold OTC. RESULTS: We show that WTP is higher for the OTC scenario and that the level of information plays a significant role in the evaluation of the OTC scenario, with more information being associated with an increase in the WTP. In contrast, the level of information provided has no impact on WTP for prescription medicine. Thus, for the kind of drug considered here (i.e. safe, not requiring medical supervision), a switch to OTC status can be expected to be all the more beneficial, as the patient is provided with more information concerning the capability of the drug. CONCLUSIONS: Our results shed light on one of the most challenging issues that health policy makers are currently faced with, namely the threat of a bird flu pandemic. Drug delivery is a critical component of pandemic influenza preparedness. Furthermore, the congruence of our results with the agency and demand theories provides an important test of the validity of using WTP based on CV methods.

The male-female health-survival paradox: a survey and register study of the impact of sex-specific selection and information bias.

Ann Epidemiol. 2009 Jul; 19(7): 504-11
Oksuzyan A, Petersen I, Stovring H, Bingley P, Vaupel JW, Christensen K

PURPOSE: This study examined whether the health-survival paradox could be due partially to sex-specific selection and information bias in surveys. METHODS: The study is based on the linkage of three population-based surveys of 15,330 Danes aged 46-102 years with health registers covering the total Danish population regarding hospitalizations within the last 2 years and prescription medicine within 6 months before the baseline surveys. RESULTS: Men had higher participation rates than women at all ages. Hospitalized women and women taking medications had higher participation rate compared with nonhospitalized women (difference=0.7%-3.0%) and female nonusers (difference=0.8%-7.6%), respectively, whereas no consistent pattern was found among men according to hospitalization or medication use status. Men used fewer medications than women, but they underreported medication use to a similar degree as did women. CONCLUSIONS: Hospitalized women, as well as women using prescription medicine, were slightly overrepresented in the surveys. Hence, the study found some evidence that selection bias in surveys may contribute to the explanation of the health-survival paradox, but its contribution is likely to be small. However, there was no evidence for sex-specific reporting of medication use among study participants.

Whom do older adults trust most to provide information about prescription drugs?

Am J Geriatr Pharmacother. 2009 Apr; 7(2): 105-16
Donohue JM, Huskamp HA, Wilson IB, Weissman J

BACKGROUND: Cost-related nonadherence to medieations is common among older adults, yet physician-patient communication about medication cost concerns is infrequent. One factor affecting communication and adherence may be older adults' confidence in the information about prescription drugs provided by physicians and other sources. OBJECTIVES: This study was conducted to identify which source older adults most trust to provide information on drugs and to examine the relationship between older patients' trust in physicians to provide price information and the occurrence of cost-related nonadherence. METHODS: We conducted a cross-sectional national telephone survey of individuals aged > or =50 years who were taking at least 1 prescription medication. Respondents were asked how much they would trust various sources (physician, pharmacist, nurse, insurance plan, the Internet, consumer groups, friends and family) to provide helpful information on "the price of the prescription medicine compared to others like it" and on "how well the prescription medicine will work for you compared to other medicines like it." The response options were a lot, somewhat, and not at all. Other measures of interest were respondents' beliefs concerning physicians' ability to lower drug costs and patient activation. We also evaluated the potential association between trust in physicians to deliver drug price information and cost-related medication nonadherence. RESULTS: Compared with the other sources of information studied, doctors and pharmacists were the sources that respondents were most likely to trust "a lot" to provide information on drug prices (55.6% and 61.7%, respectively) and to provide information on drug effectiveness (79.9% and 66.4%). Less than half (42.3%) of respondents who said that they trusted their doctor to provide drug price information "somewhat" or "not at all" agreed that there are ways doctors could lower drug costs (P = 0.01 vs those who trusted their doctor "a lot"). Adults aged > or =65 years were more likely than those aged 50 to 64 years to trust their doctors "a lot" to provide information on drug prices (odds ratio [OR] = 1.44; 95% CI, 1.08-1.92); the same was true of members of minority groups compared with white respondents (OR = 1.72; 95%) CT, 1.1 3-2.61 ). Among individuals with high drug spending, those who placed "a lot" of trust in their doctors to provide price information were less likely than those who trusted their doctor "somewhat" or "not at all" to have cost-related nonadhcrence (OR = 0.40; 95% CI, 0.20-0.78). CONCLUSIONS: In this survey, older adults trusted physicians and pharmacists more than the other sources studied to provide information on prescription drugs. Trust in physicians to provide price information was an important moderator of the effect of high drug spending on cost-related nonadhcrence. Efforts to provide patients and their providers with comparative data on drug prices and effectiveness may reduce cost-related nonadhcrence.

Striving for quality use of medicines: how effective is Australia's ban on direct-to-consumer prescription medicine advertising?

J Law Med. 2009 Feb; 16(4): 666-83
Brown S

The potential for both positive and negative effects arising from direct-to-consumer advertising of prescription medicines challenges health policymakers to develop regulatory schemes which selectively capture the positive aspects of the practice. Australia has dealt with this quandary by banning the practice, while New Zealand and the United States permit it. However, in recent times pharmaceutical companies have been increasingly successful in introducing promotional materials into the Australian market. This article demonstrates that the Australian ban is consistent with striving for the major policy goal of quality use of medicines, thus providing the basis for arguing that solutions to strengthen the ban against the identified threats ought to be implemented. Quality use of medicines can be most effectively achieved via the combined effect of the strengthened ban and the mimicking of the limited positive aspects of direct-to-consumer advertising by government provision of non-promotional information to consumers.

[Suitability of the Personal Electronic Medication profile for estimation of medication compliance]

Ugeskr Laeger. 2009 Mar 9; 171(11): 899-903
Andersen LS, Kjeldsen LJ, Haugbølle LS

INTRODUCTION: Denmark operates a so-called personal electronic medication record (PEM) containing information about prescription medicine purchased by patients. This study examined the PEM compliance module in order to determine its suitability for evaluating patient compliance. MATERIAL AND METHODS: We collected data from 256 patients who participated in an intervention project conducted on Funen among users of antihypertensive medication. Data were collected from patient information in PEM. The data were used to compare three types of compliance which were all based on information in PEM: 1) calculating compliance, 2) compliance chart, 3) DDD (defined daily doses) chart. RESULTS: The 256 patients used a total of 1,062 medications (1-13 medications per person). It was not possible to calculate compliance for 240 (23%) medications distributed on 141 patients (55%). Compliance was highest for method 1 and lowest for method 3; conversely, non-compliance was lowest for method 1 and highest for method 3. Combining the three revealed a considerable discrepancy (44-66%) in the assessment of patient compliance. CONCLUSION: The PEMs lacked information for approx. 1/5 of the medications; consequently it was not possible to calculate compliance for these persons. The results indicate that for compliance assessment, PEM quality is less than optimal.

How do Australian metropolitan and rural pharmacists counsel consumers with prescriptions?

Pharm World Sci. 2009 Jun; 31(3): 394-405
Puspitasari HP, Aslani P, Krass I

OBJECTIVE: To investigate and compare counselling provided by community pharmacists in Australian metropolitan and rural pharmacies. METHODS: Mail surveys to 650 randomly selected New South Wales (NSW) community pharmacies [385 (59%) metropolitan, 265 (41%)] rural were conducted. MAIN OUTCOME MEASURE: The rates of verbal and written prescription medicine information and type of information given both for new and regular medicines were determined. The rates of verbal information were also explored by assessing how likely pharmacists were to counsel based on hypothetical cases for new prescription medicines. RESULTS: A response-rate of 42% was obtained from 116/378 (31%) metropolitan and 156/262 (60%) rural pharmacies. A higher proportion of metropolitan than rural pharmacists reported providing verbal information for more than 50% of new prescriptions (P < 0.001) and for more than 50% of regular prescriptions (P < 0.001). In contrast, a higher proportion of rural than metropolitan pharmacists reported giving out Consumer Medicine Information leaflets (CMIs) for more than 50% of new prescriptions (P = 0.007). After controlling for any identified confounders, metropolitan pharmacists were 4.6 times more likely to verbally counsel on new prescriptions and 3.1 times more likely to counsel on regular prescriptions, while rural pharmacists were 2.4 times more likely to give out CMIs for new prescriptions. Information on medicine administration was provided more frequently than information on the safety aspects of medicine, with both types of information being more frequently given for new than regular prescription medicines. There was variability in responses to hypothetical cases and not all respondents were highly likely to counsel on all new prescriptions. CONCLUSION: Metropolitan pharmacists tended to provide verbal information, while rural pharmacists tended to give out written information. The respondents prioritised counselling on medicine administration for new prescription medicines. Not all respondents, however, were highly likely to counsel on all new prescriptions.

Perception of prescription medicine sample packs among Australian professional, government, industry, and consumer organizations, based on automated textual analysis of one-on-one interviews.

Clin Ther. 2008 Dec; 30(12): 2461-73
Kyle GJ, Nissen L, Tett S

BACKGROUND: Prescription medicine samples provided by pharmaceutical companies are predominantly newer and more expensive products. The range of samples provided to practices may not represent the drugs that the doctors desire to have available. Few studies have used a qualitative design to explore the reasons behind sample use. OBJECTIVE: The aim of this study was to explore the opinions of a variety of Australian key informants about prescription medicine samples, using a qualitative methodology. METHODS: Twenty-three organizations involved in quality use of medicines in Australia were identified, based on the authors' previous knowledge. Each organization was invited to nominate 1 or 2 representatives to participate in semistructured interviews utilizing seeding questions. Each interview was recorded and transcribed verbatim. Leximancer v2.25 text analysis software (Leximancer Pty Ltd., Jindalee, Queensland, Australia) was used for textual analysis. The top 10 concepts from each analysis group were interrogated back to the original transcript text to determine the main emergent opinions. RESULTS: A total of 18 key interviewees representing 16 organizations participated. Samples, patient, doctor, and medicines were the major concepts among general opinions about samples. The concept drug became more frequent and the concept companies appeared when marketing issues were discussed. The Australian Pharmaceutical Benefits Scheme and cost were more prevalent in discussions about alternative sample distribution models, indicating interviewees were cognizant of budgetary implications. Key interviewee opinions added richness to the single-word concepts extracted by Leximancer. CONCLUSIONS: Participants recognized that prescription medicine samples have an influence on quality use of medicines and play a role in the marketing of medicines. They also believed that alternative distribution systems for samples could provide benefits. The cost of a noncommercial system for distributing samples or starter packs was a concern. These data will be used to design further research investigating alternative models for distribution of samples.

The Australian rise of esomeprazole-was expenditure on samples a contributor?

Pharmacoepidemiol Drug Saf. 2009 Jan; 18(1): 62-8
Kyle GJ, Nissen LM, Tett SE

BACKGROUND: Administrative data from the Australian Pharmaceutical Benefits Scheme (PBS) showed rapid growth of esomeprazole dispensing when it was launched. Australia has universal prescription medicine coverage (the PBS), which included esomeprazole from August 2002. Free samples of new medicines are commonly provided to doctors. OBJECTIVES: To determine if a relationship exists between marketing expenditure on samples and the dispensing rate for esomeprazole in Australia between June 2002 and September 2006. METHODS: Quarterly sample expenditures at product/brand level for proton pump inhibitors (PPIs) for Australian general practitioners were obtained for July 2002 to September 2006. Corresponding PBS dispensing data were obtained for all PPIs and converted to defined daily dose (DDD)/1000 population/day. Spending on samples was calculated as dollars per dispensed prescription and plotted against time on the Australian market. RESULTS: Total PPI usage increased from 34.2 to 50.8 DDD/1000 population/day over the study period. Expenditure on samples per dispensed prescription was higher when a PPI was new on the market and diminished over 5-6 years to a relatively constant level. The rapid decline in this ratio was demonstrated by a case study following esomeprazole from launch in Australia for almost 5 years clearly demonstrating the initial investment to drive sales. CONCLUSION: A relationship appears to exist between expenditure on esomeprazole samples and its usage in Australia. A high initial investment was followed by a rapid reduction in cost per prescription dispensed, predominantly due to growth in market share. This trend was consistent with other PPIs.

Surveillance of a recently switched non-prescription medicine (Diclofenac) using a pharmacy-based approach.

Pharmacoepidemiol Drug Saf. 2000 May; 9(3): 207-14
Gauld NJ, Shaw JP, Emmerton LM, Pethica BD

PURPOSE: Postmarketing surveillance of prescription medicines is a routine practice, yet similar evaluation of non-prescription medicines, including those recently switched from prescription status, is uncommon. This study presents the methodologic issues and limitations of the use of pharmacies in the 'post-reclassification' surveillance of oral diclofenac potassium 25 mg which had been recently switched from physician prescription to non-prescription sale. METHODS: Consenting user-purchasers were recruited from 175 New Zealand pharmacies over 4 months. Purchasers were mailed a questionnaire for completion 7 days post-purchase. Those purchasers who met criteria for being potentially 'at risk' of adverse events were re-surveyed 30 days post-purchase. A descriptive analysis was carried out using t-test and chi-square as appropriate. These results were compared to those from other types of studies in this area. RESULTS: The 1240 recruited purchasers returned 990 valid questionnaires (80% response). Of these 557 (56%) met 'at risk' criteria and received the second questionnaire with 480 valid returns (86.2% response). CONCLUSIONS: Useful data was gathered on the 'real-life' usage of a medicine recently reclassified from prescription to non-prescription sale. The use of community pharmacies as recruiting centres was found to be effective. Copyright (c) 2000 John Wiley & Sons, Ltd.

High school to college transition: a profile of the stressors, physical and psychological health issues that affect the first-year on-campus college student.

J Cult Divers. 2008; 15(3): 143-7
Hicks T, Heastie S

The purpose of this article is to profile identified stressors, physical and psychological health issues that affect first-year campus college students as they transition from high school to college. The Health Behaviors, Self-Rated Health and Quality of Life (QOL) questionnaire was administered to 514 university college students. Results from this study determined that there were significant differences among student life stressors and physical and psychological health status between first-year on-campus and first-year off-campus college students. Most importantly this study documented compelling information regarding selection of roommate, poor housing, chronic and temporary diseases, injury and prescription medicine among college students attending a university in North Carolina. Implications for university health administrators, student affairs personnel, counselors and faculty are discussed.

Australian consumer responses to DTCA and other pharmaceutical company sponsored advertisements.

Aust N Z J Public Health. 2008 Oct; 32(5): 471-8
Hall DV, Jones SC

OBJECTIVE: This study aimed to elicit and compare the responses of Australian consumers towards New Zealand (NZ) direct-to-consumer-advertisements (DTCA) for prescription medicines and matched pharmaceutical company-sponsored advertisements from Australia. METHODS: A survey questionnaire was mailed to a random sample of residents in a metropolitan area in NSW. Potential participants were randomised to receive one of four different advertisements: two for weight loss and two for Alzheimer's disease. A total of 413 responses were received and analysed. RESULTS: Participants reported that they were not likely to ask for a prescription from their doctor as a result of seeing any of the advertisements in the study. The Australian disease awareness advertisement that did not refer to a medicinal treatment was perceived as more valuable than the NZ DTCA or other Australian advertisement. Overall, participants found it easier to make sense of the more informational advertisements, and felt that there was insufficient information regarding the disease/condition and treatments in the more emotive and transformational advertisements. CONCLUSIONS: While there is concern over potential negative effects of pharmaceutical-sponsored disease awareness advertisements, this study found that Australian consumers perceived an informational advertisement with a list of disease symptoms to be valuable. IMPLICATIONS: These findings contribute to debate in New Zealand and Australia regarding DTCA and disease awareness advertising, and have the potential to inform guidelines relevant to the advertising of prescription medicine in each country.

AAS, growth hormone, and insulin abuse: psychological and neuroendocrine effects.

Ther Clin Risk Manag. 2008 Jun; 4(3): 587-97
Graham MR, Evans P, Davies B, Baker JS

The nontherapeutic use of prescription medicines by individuals involved in sport is increasing. Anabolic-androgenic steroids (AAS) are the most widely abused drug. Much of our knowledge of the psychological and physiological effects of human growth hormone (hGH) and insulin has been learned from deficiency states. As a consequence of the Internet revolution, previously unobtainable and expensive designer drugs, particularly recombinant human growth hormone (rhGH) and insulin, have become freely available at ridiculously discounted prices from countries such as China and are being abused. These drugs have various physiological and psychological effects and medical personnel must become aware that such prescription medicine abuse appears to be used not only for performance and cosmetic reasons, but as a consequence of psychological pre-morbidity.

Non-steroidal anti-inflammatory drugs, Cyclooxygenase-2 inhibitors and paracetamol use in Queensland and in the whole of Australia.

BMC Health Serv Res. 2008; 8: 196
Barozzi N, Tett SE

BACKGROUND: Cross national drug utilization studies can provide information about different influences on physician prescribing. This is important for medicines with issues around safety and quality of use, like non selective non-steroidal anti-inflammatory drugs (ns-NSAIDs) and cyclo-oxygenase-2 (COX-2) inhibitors. To enable comparison of prescription medicine use across different jurisdictions with a range of population sizes, data first need to be compared within Australia to understand whether use in a smaller sub-population may be considered as representative of the total use within Australia. The aim of this study was to compare the utilization of non selective NSAID, COX-2 inhibitors and paracetamol between Queensland and Australia. METHOD: Dispensing data were obtained for concession beneficiaries for Australia for ns-NSAIDs, COX-2 inhibitors and paracetamol subsidized by the PBS over the period 1997-2003. The same data were purchased for Queensland. Data were converted to Defined Daily Dose (DDD)/1000 beneficiaries/day (World Health Organization anatomical therapeutic chemical classification, 2005). RESULTS: Total NSAID and paracetamol consumption were similar in Australia and Queensland. Ns-NSAID use decreased sharply with the introduction of COX-2 inhibitors (from approximately 80 to 40 DDD/1000 beneficiaries/day). Paracetamol was constant (approximately 45 DDD/1000 beneficiaries/day). COX-2 inhibitors consumption was initially higher in Queensland than in the whole of Australia. CONCLUSION: Despite initial divergence in celecoxib use between Queensland and Australia, the use of ns-NSAIDs, COX-2 inhibitors and paracetamol overall, in concession beneficiaries, was comparable in Australia and Queensland.

[Application of the medicine profile in an ambulatory setting]

Ugeskr Laeger. 2008 Aug 11; 170(33): 2427-32
Reuther LØ, List SB, Christensen HR

INTRODUCTION: A person with a digital signature can access his or her own personal electronic medicinal profile (PEM) which can also be accessed by the person's prescribing doctors. The PEM provides an overview and contains an overview of the prescription medicine sold to the patient over the previous two years. MATERIALS AND METHODS: Randomly-selected geriatric ambulatory patients were included. Accordance between physicians' medication records and the PEM was calculated. Moreover, the prescribing ambulatory doctor and the patient's general practitioner were asked if the PEM could contribute with non-recognized information about patients' prescription medicine. RESULTS: We found a 13-20% discrepancy between physicians' medication records and PEMs, involving 50-60% of the patients. In most cases, access to the PEM significantly corrected the discrepancies. Discrepancies were neither correlated to gender, age nor to the amount of prescription medicine. Discrepancies were judged to be serious or influential. CONCLUSION: The PEM provides insight into unrecognized information about patients' prescription medicine and access to the PEM bridges the gap between primary and secondary health care. Easier access to the digital signature, inclusion of over-the-counter drugs, and improved protection against misuse would further improve the PEM and ensure access to updated drug information.