[Impact of new therapeutic products for the treatment of chronic obstructive pulmonary disease and asthma in primary care in Madrid between 1996 and 2005]. / Impacto de las novedades terapéuticas para el tratamiento de la enfermedad pulmonar obstructiva crónica y el asma en atención primaria de Madrid, entre 1996 y 2005.

OBJECTIVES: To analyze the trend of use of new drugs for the treatment of chronic obstructive pulmonary disease in primary care of Madrid (Spain) between 1996 and 2005, and to evaluate its impact in terms of supply, use and costs. METHODS: Drug utilization study of new products of the R03 group (Anatomical Therapeutic Chemical Classificaction System: drugs for obstructive airway diseases) prescribed by doctors of primary care of Madrid, during 1996 and 2005. Information on drug utilization and cost was obtained from the prescription database. Date was expressed in daily doses defined by 1,000 inhabitants and day. RESULTS: The supply experiences few quantitative variations although of great qualitative interest, when disappearing drugs without therapeutic utility and commercializing 6 therapeutic new products. In 2005, the use of the 6 new products generates 28.03% of the total of the consumption and 79% of the costs. The new drugs of greater impact are salmeterol/fluticasone and tiotropio. CONCLUSIONS: The supply of medicines qualitatively improves when disappearing drugs without therapeutic utility. The consumption of therapeutic new products has a great impact on the total consumption of the R03 group and, mainly, in the costs by its elevated price, in spite of contributing only limited therapeutic advantages. The new drugs have been gotten up at great speed to the prescription.

Impacto de las novedades terapéuticas para el tratamiento de la enfermedad pulmonar obstructiva crónica y el asma en atención primaria de Madrid, entre 1996 y 2005 / Impact of new therapeutic products for the treatment of chronic obstructive pulmonary disease and asthma in primary care in Madrid between 1996 and 2005

Objetivos: Analizar la tendencia de utilización de nuevos medicamentos para el tratamiento de las enfermedades obstructivas de las vías aéreas en atención primaria de Madrid entre 1996 y 2005, y evaluar su impacto en términos de oferta, consumo y costes. Métodos: Estudio de utilización de medicamentos de novedades terapéuticas del grupo R03 («medicamentos para enfermedades obstructivas de las vías aéreas») prescritos por médicos de atención primaria de Madrid, durante 1996 y 2005. Los datos de consumo y gasto a PVP provienen de la facturación de recetas. El consumo se expresa en dosis diarias definidas por 1.000 habitantes y día. Resultados: La oferta experimenta pocas variaciones cuantitativas aunque de gran interés cualitativo, al desaparecer fármacos sin utilidad terapéutica y comercializarse 6 novedades terapéuticas. En el año 2005, la utilización de estas últimas genera el 28,03% del total del consumo y el 79% de los costes. Las novedades de mayor impacto son salmeterol/fluticasona y tiotropio. Conclusiones: La oferta de medicamentos mejora cualitativamente al desaparecer los fármacos sin utilidad terapéutica. La prescripción de novedades terapéuticas tiene un gran impacto sobre el consumo total de los medicamentos del grupo R03 y, sobre todo, en los costes generados, dado su elevado su precio; sin embargo, aportan limitadas ventajas terapéuticas. Los nuevos medicamentos se han incorporado a gran velocidad a la prescripción (AU)

Objectives: To analyze the trend of use of new drugs for the treatment of chronic obstructive pulmonary disease in primary care of Madrid (Spain) between 1996 and 2005, and to evaluate its impact in terms of supply, use and costs. Methods: Drug utilization study of new products of the R03 group (Anatomical Therapeutic Chemical Classificaction System: drugs for obstructive airway diseases) prescribed by doctors of primary care of Madrid, during 1996 and 2005. Information on drug utilization and cost was obtained from the prescription database. Date was expressed in daily doses defined by 1,000 inhabitants and day. Results: The supply experiences few quantitative variations although of great qualitative interest, when disappearing drugs without therapeutic utility and commercializing 6 therapeutic new products. In 2005, the use of the 6 new products generates 28.03% of the total of the consumption and 79% of the costs. The new drugs of greater impact are salmeterol/fluticasone and tiotropio. Conclusions: The supply of medicines qualitatively improves when disappearing drugs without therapeutic utility. The consumption of therapeutic new products has a great impact on the total consumption of the R03 group and, mainly, in the costs by its elevated price, in spite of contributing only limited therapeutic advantages. The new drugs have been gotten up at great speed to the prescription (AU)

Coordinación de servicios sociosanitarios para la mejora de la prescripción y dispensación farmacológica en una residencia de ancianos / Coordination of geriatric care to improve drug prescription and dispensation in a nursing home

Objetivo: implementar un programa de coordinación entre un centro de salud (CS), un centro residencial geriátrico (CRG) y una oficina de farmacia (OF) como estrategia de mejora de la gestión clínica-asistencial de pacientes residentes en centros geriátricos y evaluar su impacto en términos de eficiencia en la utilización de recursos sanitarios y seguridad del paciente. Material y método: estudio descriptivo y de intervención antes-después con 3 fases: evaluación de la situación, intervención y medida de resultados en el CRG. Se determinan indicadores en relación con la organización, protocolización de proceso, calidad de prescripción farmacéutica y seguimiento farmacoterapéutico en la OF. Se realizó un análisis de situación identificando 6 áreas de mejora en relación con la asistencia sanitaria prestada a los pacientes del CRG: coordinación entre unidades gestoras y asistenciales, prescripción de medicamentos y productos sanitarios, circuito para la realización de pruebas analíticas, suministro de material sanitario, control de pacientes en tratamiento con anticoagulación oral y seguimiento farmacoterapéutico en la OF. Se instauraron acciones correctivas en relación con la coordinación así como con la protocolización de 5 de los procesos clínico-asistenciales descritos anteriormente. La OF inició un programa para el seguimiento farmacoterapéutico de los pacientes del CRG. Resultados: de los indicadores propuestos se observa una disminución del importe medio por envases en un 24%, y mejoran los indicadores de calidad de prescripción seleccionados (especialidades farmacéuticas genéricas [%], antagonistas de receptores de angiotensina II [%], antidiabéticos de elección [%] e inhibidores de la enzima conversiva de angiotensina de elección [%]). Se ha realizado seguimiento farmacoterapéutico en la OF a 82 pacientes detectando 61 problemas relacionados con medicamentos. Conclusiones: los resultados de este programa de intervención se muestran útiles para mejorar la calidad de la prescripción farmacéutica y utilización de los recursos sanitarios en pacientes geriátricos de una residencia. La metodología se ha mostrado apropiada para promover un uso eficiente de los recursos sanitarios y potenciar la seguridad de los pacientes

Objective: to implement a coordination program among a health center, a nursing home, and a community pharmacy as a strategy to improve the management of nursing home residents and to evaluate the impact of this strategy on the efficiency of health resource utilization and patient safety. Material and method: we performed a descriptive before-after intervention study in three phases: evaluation of the situation, intervention, and measurement of the results in the nursing home. Indicators related to organization, standardization of the process, quality of drug prescription, and pharmacotherapeutic follow-up in the community pharmacy were determined. An analysis of the situation was performed by identifying six areas of improvement in relation to the healthcare provided to the nursing home residents: coordination between management and clinical units, prescription of drugs and healthcare products, the circuit for laboratory tests, supply of healthcare material, monitoring of patients under treatment with oral anticoagulants and pharmacotherapeutic follow-up in the community pharmacy. Corrective measures were implemented in relation to the coordination and standardization of five of the above-mentioned areas. The community pharmacy initiated a program for the pharmacotherapeutic follow-up of patients in the nursing home. Results: of the indicators proposed, a 24% reduction in the mean cost due to medication. Improvement was also noted in the selected indicators of prescription quality (% generic drugs, % angiotensin II receptor antagonists, % antidiabetic agents of choice, and % angiotensin converting enzyme inhibitors of choice). Pharmacotherapeutic follow-up of 82 patients was performed in the community pharmacy and 61 drug-related problems were detected. Conclusions: the results of this intervention program are useful to improve drug prescription and healthcare resource use in nursing home residents. The methodology has been shown to be appropriate to foment the efficient use of healthcare resources and patient safety

[Drug prescription for chronic obstructive pulmonary disease and asthma by primary care physicians in the Spanish autonomous community of Madrid, 1996-2002]. / Utilización de medicamentos para la EPOC y el asma en atención primaria en la Comunidad de Madrid (1996-2002).

OBJECTIVE: To identify trends in the drug prescription used to treat chronic obstructive pulmonary disease (COPD) and asthma at the primary care level in Madrid between 1996 and 2002, and to assess the repercussion of new treatments. PATIENTS AND METHODS: We analyzed information on primary care general practitioners' and pediatricians drug prescription from the R03 group (drugs for obstructive airway diseases) of the Anatomical Therapeutic Chemical Classification System. Drug consumption was measured by recording the number of packages charged to the Spanish National Health Service and dispensed in pharmacies in the Spanish autonomous community of Madrid between 1999 and 2002. Consumption was expressed as defined daily dose per 1000 inhabitants per day. RESULTS: Drug use expressed as defined daily dose per 1000 inhabitants per day for COPD and asthma in Madrid increased by 18.48% between 1996 and 2002. The use of inhalants increased by 33.5% over the same period. The most marked differences were the increase in the number of patients treated with selective beta2 adrenergic agonists, anticholinergics, and combinations of fixed doses of long acting beta2 agonists with corticosteroids. The most-used drugs in 2002 were selective beta2 adrenergic agonist inhalants (37.7%), anticholinergics (22.5%), corticosteroids (19.5%), combinations of fixed doses of long acting beta2 adrenergic agonists with corticosteroids (10.5%) band xanthines (5.03%). In 2002, the prescription of 5 new treatments amounted to 15.76% of total use of COPD and asthma drugs (R03 group). CONCLUSIONS: Drug use for obstructive diseases of the airways showed a sharp increase between 1996 and 2002. Changes in patterns of use were observed, new treatments being quickly adopted, modifying the profile of drug prescription for the management of COPD and asthma.

Utilización de medicamentos para la EPOC y el asma en atención primaria en la Comunidad de Madrid (1996-2002) / Drug prescription for Chronic Obstructive Pulmonary Disease and asthma by primary care physicians in the spanish autonomous Community of Madrid, 1996-2002

Objetivo: Conocer la tendencia en la utilización de los medicamentos para el tratamiento de la enfermedad pulmonar obstructiva crónica (EPOC) y el asma en atención primaria de Madrid entre 1996 y 2002, y evaluar la repercusión de las novedades terapéuticas. Pacientes y métodos: Se ha analizado la información sobre el consumo, en número de envases, de los medicamentos incluidos en el grupo R03 ("Medicamentos para enfermedades obstructivas de las vías aéreas") que prescribieron médicos de familia y pediatras de atención primaria, y que, facturados con cargo al Sistema Nacional de Salud, se dispensaron en las oficinas de farmacia de la Comunidad de Madrid en el período 1996-2002. El consumo se expresa en dosis diarias definidas por 1.000 habitantes y día. Resultados: El consumo de medicamentos, expresado en dosis diarias definidas por 1.000 habitantes y día, para la EPOC y el asma en Madrid aumentó un 18,48% entre 1996 y 2002. La utilización de la vía inhalada creció un 33,5% en dicho período. Las variaciones más destacables se centraron en el incremento del número de pacientes tratados con agonistas adrenérgicos Beta2 selectivos, anticolinérgicos y asociaciones a dosis fijas de agonistas Beta2 de acción larga con glucocorticoides. Los grupos más consumidos en 2002 fueron los agonistas adrenérgicos Beta2 selectivos por vía inhalada (37,7%), anticolinérgicos (22,5%), glucocorticoides (19,5%), asociaciones a dosis fijas de agonistas adrenérgicos Beta2 de acción larga junto con glucocorticoides (10,5%) y xantinas (5,03%). En 2002 la prescripción de 5 novedades terapéuticas generó el 15,76% del total del consumo de los fármacos utilizados en la EPOC y el asma (grupo R03). Conclusiones: El consumo de medicamentos para enfermedades obstructivas de las vías aéreas muestra un notable crecimiento entre 1996 y 2002. Se observan cambios en los patrones de utilización, incorporándose a gran velocidad nuevas opciones terapéuticas que modifican el perfil de prescripción de los medicamentos utilizados en el manejo de la EPOC y el asma

Objective: To identify trends in the drug prescription used to treat chronic obstructive pulmonary disease (COPD) and asthma at the primary care level in Madrid between 1996 and 2002, and to assess the repercussion of new treatments. Patients and methods: We analyzed information on primary care general practitioners´ and pediatricians´ drug prescription from the R03 group (drugs for obstructive airway diseases) of the Anatomical Therapeutic Chemical Classification System. Drug consumption was measured by recording the number of packages charged to the Spanish National Health Service and dispensed in pharmacies in the Spanish autonomous community of Madrid between 1999 and 2002. Consumption was expressed as defined daily dose per 1000 inhabitants per day. Results: Drug use expressed as defined daily dose per 1000 inhabitants per day for COPD and asthma in Madrid increased by 18.48% between 1996 and 2002. The use of inhalants increased by 33.5% over the same period. The most marked differences were the increase in the number of patients treated with selective Beta2 adrenergic agonists, anticholinergics, and combinations of fixed doses of long acting Beta2 agonists with corticosteroids. The most-used drugs in 2002 were selective Beta2 adrenergic agonist inhalants (37.7%), anticholinergics (22.5%), corticosteroids (19.5%), combinations of fixed doses of long acting Beta2 adrenergic agonists with corticosteroids (10.5%) band xanthines (5.03%). In 2002, the prescription of 5 new treatments amounted to 15.76% of total use of COPD and asthma drugs (R03 group). Conclusions: Drug use for obstructive diseases of the airways showed a sharp increase between 1996 and 2002. Changes in patterns of use were observed, new treatments being quickly adopted, modifying the profile of drug prescription for the management of COPD and asthma