Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 16, Building 50, 23538, Lübeck, Germany.
Department of Gynecology and Obstetrics, Philipps University of Marburg, Baldingerstr., 35043, Marburg, Germany.
BMC Health Serv Res. 2020 Jul 13;20(1):651. doi: 10.1186/s12913-020-05501-1.
An important contribution to well-being of human beings can be observed by the use of self-medication products that is reflected in the constantly growing volume of over-the-counter (OTC) drugs. The aim of the current study was to extend the measurement concept for OTCs by exploring the relevance of the peripheral assortment provided by the widely accepted framework of the Anatomical Therapeutical and Chemical (ATC) classification of the WHO.
The focus was on the prescriptions and drug-related receipts submitted by privately insured persons to 18 private health insurers (PHIs) in Germany from the year 2016. The age- and gender-specific average claims amount per risks of outpatient drug expenditure were used as weights to scale up the relative distributions of the item amounts. The ATC-classification defines the commodity groups and discriminates between the main and the peripheral assortment. A descriptive analysis assessed the OTC frequencies and sum scores of the product groups within the main and peripheral assortment whereby the study group explored and assessed the relevance of each category independently according to the OTCs and integrative medicines.
The analysis included 22.1 Mio. packages from the main assortment and examined 10.1 Mio. packages from the peripheral assortment. The latter was examined thoroughly and the commodity groups "Pharmaceutical food products", "Medicinal products for special therapy options" and particular "Hygiene and body care products" meet the defined requirements for OTCs relevant for integrative medicines. A high proportion of OTC products from the peripheral assortment was associated with the categories "medicinal products for special therapy options". Homeopathy and anthroposophy present two special therapy options, which are relevant for the extended OTC measurement.
The analysis of OTC drugs is feasible when the main and the peripheral assortment is available and enable to integrate about 18% of all OTCs, which are neglected by the common ATC-based approach. The presented extended approach may help to identify potential users of OTCs or people in need of OTC use. In case of the highly disputed homeopathy and anthroposophy products, more research among interactions with prescriptions drugs (Rx), nutrition's and other potentially harmful exposures is recommended.
通过使用自我药疗产品，可以观察到对人类福祉的一个重要贡献，这体现在不断增长的非处方（OTC）药物数量上。本研究的目的是通过探索广泛接受的世界卫生组织（WHO）解剖治疗学和化学（ATC）分类框架提供的周边产品的相关性，扩展 OTC 的测量概念。
研究重点是 2016 年德国 18 家私人健康保险公司（PHI）收到的私人投保者的处方和与药物相关的收据。按年龄和性别划分的门诊药物支出风险的平均索赔额被用作扩大项目金额相对分布的权重。ATC 分类定义了商品组，并区分了主要和周边产品。描述性分析评估了主要和周边产品中产品组的 OTC 频率和总分，研究组根据 OTC 和综合药物独立探索和评估了每个类别的相关性。
分析包括主要产品中的 2210 万包，检查了周边产品中的 1010 万包。对后者进行了详细检查，商品组“药用食品”、“特殊治疗选择的药物”和特殊的“卫生和身体护理产品”符合综合药物相关的 OTC 定义要求。周边产品中 OTC 产品的比例较高与“特殊治疗选择的药物”类别相关。顺势疗法和人智学是两种特殊的治疗选择，对扩展的 OTC 测量具有重要意义。
当主要和周边产品可用时，分析 OTC 药物是可行的，并且可以整合约 18%的所有 OTC，这是常见的基于 ATC 的方法所忽略的。所提出的扩展方法可能有助于确定 OTC 的潜在使用者或需要使用 OTC 的人。对于有争议的顺势疗法和人智学产品，建议进行更多关于与处方药物（Rx）、营养和其他潜在有害暴露相互作用的研究。
