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OUTCOME MEASURE AND DRUG USE MEASURES ADHIN ANTONY XAVIER
Assistant ProfessorCES college., KURNOOLAndhra Pradesh
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OUTCOME MEASUREMENTThe occurrence of pharmacoepidemiological outcomes is commonly expressed by measurements such as,
• Prevalence• Cumulative incidence and • Incidence rate
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PREVALENCE It is concerned with the disease status
It is the proportion of people affected with a disease or exposed to a particular drug in a population at a given time
It is usually determined by surveying the population of interest
Prevalence varies between 0-1, it can also be expressed as a percentage
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Prevalence = A/BA- number of population with disease at a given timeB- total number of population at a given time
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• It is a measure of the risk of developing some new
condition with in a specified period of time
• It is better expressed as a proportion or as a rate
INCIDENCE:
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INCIDENCE RATE:
•It is the number of new cases per unit of person-time at risk.•It describes the probability of a new case occurring during a given time interval
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CUMMULATIVE INCIDENCE (INCIDENCE PROPORTION)
• It is the number of new cases with in a specified time period divided by the size of the population initially at risk
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Monetary unitsNumbers of prescriptionUnits of drug dispensedDefined daily dosesPrescribed daily dosesMedication adherence measurement
DRUG USE MEASURES:
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MONETARY UNITS
• Drug use has been measured in monetary units to quantify the amounts being consumed by population
• It can indicate the burden on a society from drug use
• Monetary units are convenient & can be converted to a common unit, which then allows for comparison
DISADVANTAGE:quantities of drugs actually consumed are not known & prices may vary widely
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•It has been used in research due to the availability & ease
DISADVANTAGE :
• quantities dispensed vary greatly as duration of treatment
NUMBER OF PRESCRIPTIONS
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•Units of drug dispensed like tablets, vials is easy to obtain & can be used to compare usage trends within population
DISADVANTAGE:
• No information is available on the quantities actually taken by the patient
• Determine the actual no. Of patients exposed to the drug
UNITS OF DRUG DISPENSED :
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It is the estimated avg. Maintenance dose per day of a drug when used in its major indicationIt is normally expressed as DDD\/1000 patients/ \/ dayIt is helpful in describing & comparing patterns of DU & provides denominator data for estimation of ADR rates It allows comparisons between drugs in the same therapeutic class
• DISADVANTAGE:
•problems arises when doses vary widely like with antibiotics or if the drug has more than 1 major indication
DEFINED DAILY DOSES
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PRESCRIBED DAILY DOSES •It is the average daily dose of a drug that has actually been prescribed•Calculated from representative sample of prescriptions
DISADVANTAGE:
it does not indicate number Of population exposed to drug
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MEDICATION ADHERENCE MEASUREMENTS •Biological Assays
•Pill Counts•Weight of Topical Medications•Electronic Monitoring•Pharmacy Records and Prescription Claims•Patient Interviews•Patient Estimates of Adherence