Pediatric drug prescribed pediatric medicines

Authors

  • Jurij Fürst Health Insurance Institute of Slovenia, Ljubljana, Slovenia
  • Tatja Kostnapfel National institute of Public Health, Lubljana, Slovenia
  • Mitja Kos Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia

DOI:

https://doi.org/10.6016/ZdravVestn.2983

Keywords:

quality indicator, defined daily dose, prescribing systemic antibiotics

Abstract

Background: Indicators of prescribed medicines represent selected data providing a partial insight into physicians’ work in the field of drug prescribing. They are based on the data on drug prescriptions issued. The Health Insurance Institute of Slovenia (HIIS), in cooperation with the representatives of paediatric specialty, prepared an array of drug prescribing quality indicators for paediatrics. Indicators for the 5-year period between 2014 and 2018 were analysed.

Methods: The retrospective observational study analysed the data on the medicines prescribed to children aged up to 19 years. The data were obtained from the Primary Care Prescriptions Database at the HIIS and at the National Institute of Public Health. The consumption of medications is shown according to the anatomical therapeutic chemical (ATC) classification in DDD. Medication subgroups within the ATC groups were also reviewed. The data are shown in tabular format.

Results: The number of prescriptions issued for children in 2014–2018 in Slovenia is lower by 8%, while the number of DDD prescribed in the same period was higher by 4%. The highest percentage of persons receiving at least one prescription for systemic treatment of bacterial infections was observed in the Murska Sobota HIIS regional unit, i.e., 35%, followed by regional units Krško with 34.1%, Ravne with 33.2% and Novo mesto with 32%. The fewest persons received medications in the Nova Gorica regional unit. The KK1p indicator, which reflects the value of a defined daily dose (DDD) unit or the average price per unit of all medications prescribed in Slovenia, shows a downward trend for Slovenia as well as major differences between the HIIS regional units. Compared to the baseline year, there was a 16% reduction in the proportion of children having received a prescription for an antibiotic. The reduction observed for the Nova Gorica regional unit amounted to 33%.

Conclusion: The indicators presented show an improved quality of drug prescribing for children, notably regarding systemic antibiotics. We believe the indicators are useful both for individual physicians and for decision-making at national level. They also contribute to further control of antimicrobial use in children, which is their main purpose.

Downloads

Download data is not yet available.

References

1. Nadeshkumar A, Sathiadas G, Pathmeswaran A, Ranganathan SS. Prescribing, dispensing and administration indicators to describe rational use of oral dosage forms of medicines given to children. WHO South-East Asia J Public Health. 2019;8(1):42-9.
DOI: 10.4103/2224-3151.255349
PMID: 30950430

2. Baan EJ, Janssens HM, Kerckaert T, Bindels PJ, de Jongste JC, Sturkenboom MC, et al. Antibiotic use in children with asthma: cohort study in UK and Dutch primary care databases. BMJ Open. 2018;8(11):e022979.
DOI: 10.1136/bmjopen-2018-022979
PMID: 30498039

3. Mostaghim M, Snelling T, Katf H, Bajorek B. Paediatric antimicrobial stewardship and safe prescribing: an assessment of medical staff knowledge and behaviour. Pharm Pract (Granada). 2018;16(2):1198.
DOI: 10.18549/PharmPract.2018.02.1198
PMID: 30023032

4. de Bie S, Kaguelidou F, Verhamme KM, De Ridder M, Picelli G, Straus SM, et al.; ARPEC study. Using Prescription Patterns in Primary Care to Derive New Quality Indicators for Childhood Community Antibiotic Prescribing. Pediatr Infect Dis J. 2016;35(12):1317-23.
DOI: 10.1097/INF.0000000000001324
PMID: 27626915

5. Adriaenssens N, Coenen S, Tonkin-Crine S, Verheij TJM, Little P, Gossens SJ; The ESAC Project Group. European Surveillance of Antimicrobial Consumption (ESAC): Disease-Specific Quality Indicators for Outpatient Antibiotic Prescribing. BMJ Qual Saf. 2011;20(9):764-72.
DOI: 10.1136/bmjqs.2010.049049
PMID: 21441602

6. Zavod za zdravstveno zavarovanje Slovenije. Metodologija kazalnikov kakovosti predpisovanja zdravil v splošni/družinski medicini. Ljubljana: ZZZS; 2019 [cited 2019 Aug 22]. Available from: https://partner.zzzs.si/wps/portal/portali/aizv/zdravila_in_zivila_za_posebne_zdravstvene_namene/kakovost_predpisovanja_zdravil_v_druz_medicini.

7. Zavod za zdravstveno zavarovanje Slovenije. Metodologija kazalnikov kakovosti predpisovanja zdravil za pediatrijo. Ljubljana: ZZZS; 2019 [cited 2019 Aug 22]. Available from: https://www.google.com/search?q=Metodologija+kazalnikov+kakovosti+predpisovanja+zdravil+za+pediatrijo&ie=utf-8&oe=utf-8.

8. Fürst J. Poraba zdravil z vidika racionalnega predpisovanja. In: Modul za specializante družinske medicine. 13. oktobra 2017; Ljubljana, Slovenija. Ljubljana: Zavod za zdravstveno zavarovanje Slovenije; 2017 [cited 2019 Aug 22]. Available from: https://www.mf.uni-lj.si/application/files/7315/3842/4712/MTP_fuerst.pdf.

9. Zakon o zbirkah podatkov s področja zdravstvenega varstva. UR l RS. 2000(65); 2015(47); 2018(31).

10. WHO Collaborating Centre for Drug Statistics Methodology. Definition and general consideration. Oslo: Norwegian Institute of Public Health; 2016 [cited 2019 Aug 22]. Available from: https://www.whocc.no/ddd/definition_and_general_considera/.

11. Kostnapfel T, Albreht T. Poraba ambulantno predpisanih zdravil v Sloveniji v letu 2018. Ljubljana: Nacionalni inštitut za javno zdravje; 2019.

12. European Centre for Disease Prevention and Control. Antimicrobial consumption database (ESAC-Net). Solna: ECDC; 2018 [cited 2019 Aug 22]. Available from: https://www.ecdc.europa.eu/en/antimicrobial-consumption/surveillance-and-disease-data/database.

13. Versporten A, Bielicki J, Drapier N, Sharland M, Goossens H; ARPEC project group. The Worldwide Antibiotic Resistance and Prescribing in European Children (ARPEC) point prevalence survey: developing hospital-quality indicators of antibiotic prescribing for children. J Antimicrob Chemother. 2016;71(4):1106-17.
DOI: 10.1093/jac/dkv418
PMID: 26747104

14. Williams MR, Greene G, Naik G, Hughes K, Butler CC, Hay AD. Antibiotic prescribing quality for children in primary care: an observational study. Br J Gen Pract. 2018;68(667):e90-6.
DOI: 10.3399/bjgp18X694409
PMID: 29335323

15. Piovani D, Clavenna A, Cartabia M, Bortolotti A, Fortino I, Merlino L, et al. Assessing the quality of paediatric antibiotic prescribing by community paediatricians: a database analysis of prescribing in Lombardy. BMJ Paediatr Open. 2017;1(1):e000169.
DOI: 10.1136/bmjpo-2017-000169
PMID: 29637165

16. Fürst J, Čižman M, Mrak J, Kos D, Campbell S, Coenen S, et al. The influence of a sustained multifaceted approach to improve antibiotic prescribing in Slovenia during the past decade: findings and implications. Expert Rev Anti Infect Ther. 2015;13(2):279-89.
DOI: 10.1586/14787210.2015.990381
PMID: 25495147

Published

2020-08-31

How to Cite

1.
Pediatric drug prescribed pediatric medicines. ZdravVestn [Internet]. 2020 Aug. 31 [cited 2024 Oct. 8];89(7-8):408-22. Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/2983