Clavenna Antonio, Berti Alessandra, Gualandi Lucia, Rossi Elisa, De Rosa Marisa, Bonati Maurizio
Laboratory for Mother and Child Health, Mario Negri Institute for Pharmacological Research, via G. La Masa 19, Milan 20156, Italy.
Eur J Pediatr. 2009 Feb;168(2):173-80. doi: 10.1007/s00431-008-0725-y. Epub 2008 Apr 30.
In order to evaluate the prescribing pattern in the Italian paediatric population, prescriptions involving 923,353 children under 14 years old and dispensed during 2006 by the retail pharmacies of 22 Italian local health units were analysed.
A total of 561,237 children (61%) received at least one drug prescription. The prescription prevalence rate was highest in children 3 years of age (78%), decreased with increasing age and was higher in boys than in girls (chi(2)=655; p<<0.001). Each treated child received an average of 3.2 prescriptions and 4.8 boxes.
Antibiotics and anti-asthmatics were the more prescribed therapeutic classes and represented 80% of prescriptions. Amoxicillin+clavulanic acid was the most prescribed drug (24% of the overall population; 17% of all boxes), followed by inhaled beclometasone and amoxicillin. A total of 620 different drugs were prescribed and the ten leading drugs represented 64% of the prescribed boxes. Six of the ten most prescribed drugs were the same in all age groups. Wide differences were found in the prevalence rate between the different local health units; these ranged between 50.1 and 68.4% (p<<0.001). The prescription prevalence increased in the 2000-2002 period (from 62.2 to 68.3%) and slightly decreased afterwards.
Despite some limitations, the systematic monitoring of prescriptions is a valuable tool for evaluating the appropriateness of the care.
为评估意大利儿科人群的处方模式,分析了2006年意大利22个地方卫生单位的零售药店为14岁以下的923353名儿童配药的处方情况。
共有561237名儿童(61%)至少接受了一张药物处方。处方流行率在3岁儿童中最高(78%),随年龄增长而下降,且男孩高于女孩(χ²=655;p<<0.001)。每个接受治疗的儿童平均收到3.2张处方和4.8盒药品。
抗生素和抗哮喘药是处方量较多的治疗类别,占处方的80%。阿莫西林+克拉维酸是处方量最多的药物(占总人群的24%;占所有药品盒数的17%),其次是吸入用倍氯米松和阿莫西林。总共开出了620种不同的药物,十种主要药物占所开药品盒数的64%。十种最常处方的药物中有六种在所有年龄组中相同。不同地方卫生单位之间的流行率存在很大差异;范围在50.1%至68.4%之间(p<<0.001)。处方流行率在2000 - 2002年期间有所上升(从62.2%升至68.3%),之后略有下降。
尽管存在一些局限性,但对处方进行系统监测是评估医疗适宜性的一项有价值的工具。