Wessling A, Boëthius G, Sjöqvist F
National Corporation of Pharmacies, Stockholm.
Eur J Clin Pharmacol. 1990;38(4):329-34. doi: 10.1007/BF00315570.
Prescribed doses of drugs for which individualisation of dosage is deemed necessary were recorded from one national and one local Swedish prescription monitoring study for the years 1976, 1982 and 1985. Dose patterns were analysed in order to determine whether the practice of individualising drug doses had become more widely adopted by physicians. Amongst drugs eliminated primarily by metabolism, (propranolol and amitriptyline were prescribed in highly variable doses (30-fold or more). The three commonest doses of these agents accounted for about 60% of the prescriptions. In general, doses decreased with increasing patient age. Prescribing practices for piroxicam differed markedly from those of propranolol and amitriptyline, with one fixed dose of piroxicam accounting for about 90% of all prescriptions. For drugs eliminated mainly by renal excretion (digoxin, cimetidine and atenolol) there was an 8-10-fold variation in the prescribed doses. The most frequent dose of these drugs accounted for 40-60% of the prescriptions. Doses of cimetidine and atenolol were lowered only in the oldest patients. The doses of digoxin decreased more evenly with increasing age, and were reduced in elderly patients on long-term maintenance therapy. The difference in digoxin dose between young and old patients increased during the study period. Prescription monitoring as a method for following-up drug usage may be instrumental in evaluating the effect of drug educational efforts.
从瑞典一项全国性和一项地方性处方监测研究中记录了1976年、1982年和1985年需要进行剂量个体化的规定药物剂量。分析剂量模式以确定医生对药物剂量个体化的做法是否得到更广泛采用。在主要通过代谢消除的药物中，（普萘洛尔和阿米替林的处方剂量变化很大（30倍或更多）。这些药物最常见的三种剂量约占处方的60%。一般来说，剂量随患者年龄增加而降低。吡罗昔康的处方做法与普萘洛尔和阿米替林明显不同，一种固定剂量的吡罗昔康约占所有处方的90%。对于主要通过肾脏排泄消除的药物（地高辛、西咪替丁和阿替洛尔），处方剂量有8至10倍的变化。这些药物最常用的剂量占处方的40%至60%。西咪替丁和阿替洛尔的剂量仅在最年长的患者中降低。地高辛的剂量随年龄增加下降更为均匀，长期维持治疗的老年患者剂量降低。在研究期间，年轻和老年患者地高辛剂量的差异增加。处方监测作为一种跟踪药物使用情况的方法，可能有助于评估药物教育努力的效果。
