Polić-Vižintin Marina, Štimac Danijela, Čatić Tarik, Šostar Zvonimir, Zelić Ana, Živković Krešimir, Draganić Pero
Department of Public Health, Andrija Stampar Teaching Institute of Public Health, Mirogojska cesta 16, HR-10000 Zagreb, Croatia,
Psychiatr Danub. 2014 Dec;26 Suppl 3:466-71.
The purpose of this paper was to compare outpatient consumption and quality of psychotropic drug prescribing between Croatia and Bosnia & Herzegovina 2006-2010.
Data on drug utilization from Zagreb Municipal Pharmacy and Sarajevo Public Pharmacy were used to calculate the number of defined daily doses (DDD) and DDD per 1000 inhabitants per day (DDD/TID) using the WHO Anatomical-Therapeutic-Chemical methodology.
Total utilization of psychopharmaceuticals increased in both cities; however, it was higher in Zagreb than in Sarajevo throughout the study period. The utilization of psycholeptics increased in Zagreb by 2.4% (from 74.5 to 76.3 DDD/TID) and in Sarajevo by 3.8% (from 62.4 to 64.8 DDD/TID). The utilization of anxiolytics decreased in Zagreb by 2.1% and in Sarajevo by even 18.7%. The utilization of antidepressants increased in both cities with predominance of SSRI over TCA utilization, greater in Sarajevo (96.6%) than in Zagreb (10.2%). The anxiolytic/antidepressant ratio decreased by 11.1% in Zagreb (from 2.87 to 2.55) and by 58.7% in Sarajevo (from 5.66 to 2.34). Outpatient utilization of antipsychotics increased significantly in Sarajevo, predominated by typical ones, whereas in Zagreb the utilization of antipsychotics was stable, predominated by atypical ones.
In Croatia and Bosnia & Herzegovina, there was an obvious tendency to follow western trends in drug prescribing, as demonstrated by the increased use of antidepressants and reduced use of anxiolytics. Despite some improvement observed in the prescribing quality, high use of antipsychotics with dominance of typical antipsychotics in Sarajevo points to the need of prescribing guidelines for antipsychotics.
本文旨在比较2006 - 2010年克罗地亚和波斯尼亚和黑塞哥维那门诊精神药物的消费情况及处方质量。
使用萨格勒布市药房和萨拉热窝公共药房的药物利用数据，采用世界卫生组织解剖学 - 治疗学 - 化学方法计算限定日剂量（DDD）数量及每千居民每日DDD数（DDD/TID）。
两个城市精神药物的总消费量均有所增加；然而，在整个研究期间，萨格勒布的消费量高于萨拉热窝。萨格勒布的抗精神病药物消费量增加了2.4%（从74.5 DDD/TID增至76.3 DDD/TID），萨拉热窝增加了3.8%（从62.4 DDD/TID增至64.8 DDD/TID）。萨格勒布的抗焦虑药消费量下降了2.1%，萨拉热窝甚至下降了18.7%。两个城市的抗抑郁药消费量均有所增加，其中选择性5-羟色胺再摄取抑制剂（SSRI）的使用占比超过三环类抗抑郁药（TCA），萨拉热窝（96.6%）高于萨格勒布（10.2%）。萨格勒布的抗焦虑药/抗抑郁药比例下降了11.1%（从2.87降至2.55），萨拉热窝下降了58.7%（从5.66降至2.34）。萨拉热窝门诊抗精神病药物的使用显著增加，以传统型为主，而萨格勒布抗精神病药物的使用稳定，以非传统型为主。
在克罗地亚和波斯尼亚和黑塞哥维那，药物处方呈现出明显的追随西方趋势，如抗抑郁药使用增加、抗焦虑药使用减少。尽管在处方质量方面有所改善，但萨拉热窝抗精神病药物的高使用量以及传统型抗精神病药物占主导地位表明，需要制定抗精神病药物的处方指南。
