ABSTRACT
Objective : To examine past and present status of polypharmacy, multiple drug therapy, and drug utilization survey of the antibiotics.<BR>Design : Drug utilization survey using the database of the Kagoshima University Hospital information system.<BR>Methods : Data of the presriptions issued during every May between 1985 and 1997 were extracted from the database. Monthly prescriptions were classified by the number of the drugs they included. And the doses of the antibiotics were summed up yaerly.<BR>Results : During thirteen years between 1985 and 1997, the proportion of patients receiving ten drugs or more also increased from 1.50% to 4.89%. The annual utilization doses of the antibiotics are gradually decreased. For the drug utilization review the database of the hospital information system are the useful resources.<BR>Conclusion : The billing and acounting database in the hospital information system have a few problems as the reseach data sources. On the other hand, the drug history database to which are individually transfered from the prescription order entry database in hospital information system, are able to be adaptated to the research in pharmacoepidemiology.<BR>The hospital information system including the clinical subsystems are routinely operated and a large amount of the clinical patient data are daily archieved. For this reason the drug history database are able to combine and link to the other clinical database in the hospital information system such as the clinical laboratory results or the diagnosis data. These linkage database in hospital information system are virtual pharmacoepidemiology database and the useful research resources in pharmacoepidemiology.
ABSTRACT
Objective : To examine past trend and present status of polypharmacy, multiple drug therapy, which can be a cause of serious adverse events induced by drug interactions.<BR>Design : Drug utilization survey using a database of the Kagoshima University Hospital Information System.<BR>Methods : Data of the prescriptions issued during every May between 1985 and 1994 were extracted from the database. Monthly prescriptions were classified by the number of drugs they included.Furthermore, the data were sorted by patients' ID to obtain the age distribution of patients observed in each year and the distribution of the number of drugs per prescription was analyzed in each age group.<BR>Results : The average number of medicines per prescription was increased from 3.07±2.16 (average±S.D.) in 1985 to 3.46±2.61 in 1994. During 10 years between 1985 and 1994, the proportion of patients receiving ten drugs or more also increased from 1.50%to 3.90%. There was a clear tendency that a large number of drugs were given to old patients and comparatively few drugs to young patients.Proportion of the old patients over 59 years of age increased linearly from 25.71%in 1985 to 35.37% in 1994.<BR>Conclusion : The average number of medicines per prescription was increased during 10 years. This trend is considered to be attributable in part to the increase in the proportion of the old patients. The concomitant use of so many drugs is a problem and a rule for diminishing returns recently adopted as a reimbursement policy of health insurance system has been applied to prescriptions with ten drugs or more. Further studies are needed to examine possible adverse outcomes and other characteristic features of multiple therapy.