Putignano Daria, Bruzzese Dario, Orlando Valentina, Fiorentino Denise, Tettamanti Alessia, Menditto Enrica
CIRFF, Center of Pharmacoeconomics, Federico II University of Naples, via Domenico Montesano 49, Naples, Italy.
Department of Public Health, Federico II University of Naples, Via Pansini, 5, Naples, 80131, Italy.
BMC Womens Health. 2017 Sep 5;17(1):73. doi: 10.1186/s12905-017-0424-9.
Drugs are the most important treatment option for most diseases, and the majority of medical consultations result in a prescription. Women and men receive different drug prescriptions and differ in therapeutic response to pharmacological therapy. This disparity is due to biological factors (sex differences) or/and behavior, lifestyle and life experience (gender differences). Sex differences in drug use have been demonstrated in several therapeutic areas; however, there is a lack of overviews on sex and gender differences of drug use in an entire population.
We conducted a descriptive cross - sectional drug use study, involving the entire Italian population in 2012, aimed at showing and analyzing differences between men and women as regards their exposure to drugs. The data source was IMS LifeLink Treatment DynamicsTMLRx Database and it included all prescribed drugs reimbursed by the Italian National Healthcare System in 2012 and covered 90% of the entire Italian population. The information about the prescriptions was stratified by men and women and age. Drug consumption was expressed as DDD/ 1000 ab die. Exposure to drug prescriptions was expressed as period prevalence (the proportion of the population dispensed ≥1 prescription in 2012 per 1000 inhabitants). Differences of prevalence between men and women were expressed as crude and age adjusted risk ratios with 95% CI.
Our findings suggested that the largest differences in drug prescriptions regarded drugs affecting bone structure and mineralization (RR 15.9), calcium (RR 8.6) and thyroid therapy (RR 5.4), dispensed more to women than men. Otherwise ACE inhibitors were more commonly used in men.
This is the first study exploring difference in drug use between men and women and carried out on the entire Italian population. Our findings showed substantial differences between men and women in term of prevalence of drug prescriptions. Some differences in drug use may be explained by sex differences (variations in disease prevalence and severity, pathophysiology, or by other biological differences), other differences need further investigation to explain the apparent lack of a rational medical explanation for some findings. The findings may subsequently be used to plan future studies to address differences suggesting inequity in treatment approaches.
药物是大多数疾病最重要的治疗选择，大多数医疗咨询都会开出药方。男性和女性接受不同的药物处方，对药物治疗的反应也有所不同。这种差异是由于生物学因素（性别差异）或/和行为、生活方式及生活经历（社会性别差异）导致的。药物使用中的性别差异已在多个治疗领域得到证实；然而，目前缺乏对整个人口中药物使用的性别差异的概述。
我们开展了一项描述性横断面药物使用研究，研究对象为2012年的全体意大利人口，旨在展示和分析男性和女性在药物接触方面的差异。数据来源是IMS LifeLink Treatment DynamicsTMLRx数据库，其中包括2012年意大利国家医疗保健系统报销的所有处方药，覆盖了意大利全体人口的90%。处方信息按男性和女性以及年龄进行分层。药物消费量以限定日剂量（DDD）/1000人·日表示。药物处方接触率以期间患病率表示（每1000名居民中在2012年获得≥1张处方的人口比例）。男性和女性患病率的差异以粗风险比和年龄调整风险比及95%置信区间表示。
我们的研究结果表明，药物处方差异最大的是影响骨骼结构和矿化的药物（风险比15.9）、钙（风险比8.6）和甲状腺治疗药物（风险比5.4），女性的配药量高于男性。此外，血管紧张素转换酶抑制剂在男性中使用更为普遍。
这是第一项针对全体意大利人口探索男性和女性药物使用差异的研究。我们的研究结果显示，男性和女性在药物处方患病率方面存在显著差异。药物使用中的一些差异可能由性别差异（疾病患病率和严重程度、病理生理学的变化或其他生物学差异）来解释，其他差异则需要进一步研究，以解释某些结果明显缺乏合理医学解释的情况。这些研究结果随后可用于规划未来的研究，以解决表明治疗方法存在不公平现象的差异。
