Markovic-Pekovic Vanda, Stoisavljevic-Satara Svjetlana, Skrbic Ranko
Health Insurance Fund, Republic of Srpska, Banja Luka, Bosnia and Herzegovina.
Pharmacoepidemiol Drug Saf. 2009 Apr;18(4):320-6. doi: 10.1002/pds.1704.
The objective of this study was to analyse cardiovascular medicines utilisation patterns in Republic of Srpska (Bosnia and Herzegovina) over the 2002-2006 period.
A retrospective study was taken to analyse utilisation medicines reimbursed by the Health Insurance Fund (HIF), with a focus on cardiovascular medicines utilisation. ATC/DDD methodology was used to monitor utilisation of medicines. Drug utilisation 90% (DU90%) method was used to determine the prescribing quality of cardiovascular medicines.
Utilisation of cardiovascular medicines accounted for more than one half of the total medicines utilisation, with an increasing trend. Most prescribed were antihypertensive medicines i.e. ACE inhibitors, both plain and in combination with thiazide diuretics, and calcium channel blockers (CCB). Utilisation of beta-blockers and thiazide diuretics remains rather low despite an overall increase in utilisation. Re-introduction of statins in 2004 instantly led to high utilisation. The number of cardiovascular medicines within DU90% segment varies from 8 in 2002 to 12 in 2006.
This study showed a constant increase in total medicines utilisation with the cardiovascular medicines as the most prescribed. DU90% is shown as a simple method for assessing general quality of medicines prescribing, which indicated that better adherence to the guidelines is needed in order to practice a more rational use of medicines and a cost-efficient use of all resources. More stratified routinely performed analyses are also needed.
本研究的目的是分析2002 - 2006年期间波斯尼亚和黑塞哥维那斯普斯卡共和国心血管药物的使用模式。
采用回顾性研究分析医疗保险基金（HIF）报销的药物使用情况，重点关注心血管药物的使用。采用ATC/DDD方法监测药物使用情况。使用药物利用90%（DU90%）方法来确定心血管药物的处方质量。
心血管药物的使用占药物总使用量的一半以上，且呈上升趋势。最常处方的是抗高血压药物，即ACE抑制剂，包括单方制剂以及与噻嗪类利尿剂的复方制剂，还有钙通道阻滞剂（CCB）。尽管总体使用量有所增加，但β受体阻滞剂和噻嗪类利尿剂的使用量仍然较低。2004年他汀类药物重新引入后立即导致了高使用率。DU90%范围内的心血管药物数量从2002年的8种变化到2006年的12种。
本研究表明药物总使用量持续增加，其中心血管药物的处方量最大。DU90%被证明是一种评估药物处方总体质量的简单方法，这表明需要更好地遵循指南，以便更合理地使用药物并有效利用所有资源。还需要进行更分层的常规分析。
