Polić-Vižintin Marina, Tripković Ingrid, Štimac Danijela, Šostar Zvonimir, Orban Mirjana
Dr Andrija Štampar Institute of Public Health, Mirogojska 16, HR-10000 Zagreb, Croatia,
Psychiatr Danub. 2016 Dec;28(4):415-419.
The aim was to determine distribution and trends in the outpatient utilization of antipsychotics to evaluate the rationality of antipsychotic drug prescribing during the ten year period.
The epidemiological method of descriptive and analytical observation was used. Data on drug utilization from Zagreb Municipal Pharmacy were used to calculate the number of defined daily doses (DDD) and DDD per 1000 inhabitants per day (DDD/TID) using the World Health Organization Anatomical-Therapeutic-Chemical methodology. The ratio of typical versus atypical antipsychotics served as an indicator on assessing the rationality of the utilization. Data on the use of anticholinergics in the treatment of neuroleptic side effects were also included.
Outpatient utilization of antipsychotics showed a declining pattern from 14.17 in 2001 to 8.42 DDD/TID in 2010. The utilization of atypical antipsychotics increased by 60% (from 3.68 to 5.89 DDD/TID), while the utilization of typical antipsychotics decreased by 76% (from 10.49 to 2.53 DDD/TID). The drugs showing the largest increase were olanzapine (from 1.21 to 2.78 DDD/TID) and quetiapine (from 0 to 0.68 DDD/TID). The typical/atypical antipsychotic ratio changed from 1:0.4 in 2001 to 1:2.3 in 2010. A 2.3-fold decrease was recorded in the utilization of anticholinergics (from 2.05 to 0.91 DDD/TID).
Total consumption of neuroleptics significantly decreased. A decrease was also recorded in the utilization of anticholinergics. Study results pointed to two favorable features, i.e. low use of typical antipsychotics and the ratio of typical and atypical antipsychotics. Implementation of the new clinical guidelines for nervous system disorders and updating of the list of reimbursable drugs with the addition of new ones contributed to the observed improvement in the prescribing patterns during the study period. Using the WHO ATC/DDD methodology and rationality indicators in the assessment of trends in the outpatient utilization of psychopharmaceuticals over a ten-year period proved efficient in the evaluation of prescribing rationality.
目的是确定抗精神病药物门诊使用情况的分布及趋势，以评估十年期间抗精神病药物处方的合理性。
采用描述性和分析性观察的流行病学方法。利用萨格勒布市药房的药物利用数据，采用世界卫生组织解剖学-治疗学-化学分类法计算限定日剂量（DDD）数及每千居民每日DDD数（DDD/TID）。典型与非典型抗精神病药物的比例用作评估使用合理性的指标。还纳入了抗胆碱能药物用于治疗抗精神病药物副作用的数据。
抗精神病药物的门诊使用呈现下降趋势，从2001年的14.17降至2010年的8.42 DDD/TID。非典型抗精神病药物的使用增加了60%（从3.68增至5.89 DDD/TID），而典型抗精神病药物的使用减少了76%（从10.49降至2.53 DDD/TID）。使用量增加最多的药物是奥氮平（从1.21增至2.78 DDD/TID）和喹硫平（从0增至0.68 DDD/TID）。典型/非典型抗精神病药物比例从2001年的1:0.4变为2010年的1:2.3。抗胆碱能药物的使用量下降了2.3倍（从2.05降至0.91 DDD/TID）。
抗精神病药物的总消费量显著下降。抗胆碱能药物的使用量也有所下降。研究结果显示出两个有利特征，即典型抗精神病药物的低使用量以及典型与非典型抗精神病药物的比例。神经系统疾病新临床指南的实施以及可报销药物清单的更新并添加新药促成了研究期间所观察到的处方模式改善。在评估十年期间精神药物门诊使用趋势时，使用世界卫生组织的ATC/DDD方法和合理性指标在评估处方合理性方面证明是有效的。
