Pearson Sallie-Anne, Pesa Nicole, Langton Julia M, Drew Annabelle, Faedo Margaret, Robertson Jane
Faculty of Pharmacy, University of Sydney, Sydney, Australia; School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia.
Pharmacoepidemiol Drug Saf. 2015 May;24(5):447-55. doi: 10.1002/pds.3756. Epub 2015 Mar 31.
Research using dispensing claims is used increasingly to study post-market medicines use and outcomes. The purpose of this review is to catalogue more than 25 years of published literature using Australia's Pharmaceutical Benefits Scheme (PBS) dispensing records.
We searched MEDLINE, PreMEDLINE and Embase and conducted author searches for studies published from 1987 to 2013. Independent reviewers screened abstracts of 3209 articles and reviewed 264 full-text manuscripts. Included studies used PBS dispensing data to measure patterns and/or outcomes of prescribed medicines use or dispensing claims to derive a proxy for a specific disease cohort or health outcome.
Of the 228 studies identified, 106 used PBS claims only (56 using claims-level data and 50 using individual-level data) and 63 studies linked individual-level PBS claims to other health data. Most commonly, studies examined trends in drug utilisation (33%), clinician and patient practices (26%), drug use and outcomes (18%) and evaluations of intervention impacts (17%). Sixty-two percent of studies using individual-level data were based on a subset of elderly Australians. Most studies focused on drug classes acting on the nervous system (36%), cardiovascular system (15%) and alimentary tract (11%). Few studies examined prescribed medicines use in children and pregnant women.
Pharmaceutical Benefits Scheme claims represent a significant resource to examine Australia's billion-dollar annual investment in prescribed medicines. The body of research is growing and has increased in complexity over time. Australia has great potential to undertake world-class, whole-of-population pharmacoepidemiological studies. Recent investment in data linkage infrastructure will significantly enhance these opportunities.
利用配药数据进行的研究越来越多地用于研究上市后药物的使用情况和结果。本综述的目的是梳理25年多来利用澳大利亚药品福利计划（PBS）配药记录发表的文献。
我们检索了MEDLINE、PreMEDLINE和Embase，并对作者进行搜索以查找1987年至2013年发表的研究。独立评审人员筛选了3209篇文章的摘要，并审阅了264篇全文手稿。纳入的研究使用PBS配药数据来衡量处方药使用的模式和/或结果，或使用配药数据来推算特定疾病队列或健康结果的替代指标。
在识别出的228项研究中，106项仅使用了PBS数据（56项使用数据层面的数据，50项使用个体层面的数据），63项研究将个体层面的PBS数据与其他健康数据相联系。最常见的是，研究考察了药物利用趋势（33%）、临床医生和患者行为（26%）、药物使用和结果（18%）以及干预影响评估（17%）。使用个体层面数据的研究中有62%基于澳大利亚老年人群体的一个子集。大多数研究关注作用于神经系统（36%）、心血管系统（15%）和消化道（11%）的药物类别。很少有研究考察儿童和孕妇的处方药使用情况。
药品福利计划数据是检验澳大利亚每年在处方药上数十亿美元投资的一项重要资源。研究主体在不断发展，且随着时间推移复杂性有所增加。澳大利亚在开展世界级的全人群药物流行病学研究方面具有巨大潜力。近期对数据链接基础设施的投资将显著增加这些机会。
