DRUG UTILIZATION STUDIES

DR.RENJU.S.RAVI MD

OVERVIEW Introduction Definition Aims & Objectives Types of drug use information Targets Tools used DUE Sources of data on DU Future perspectives.

INTRODUCTION

Developed in mid 1960s in Northern Europe & UK.

Pioneering work by Arthur Engel in Sweden & Pieter Siderius in Holland.

Ultimate goal was to assess rational drug therapy.

DEFINITION

“the marketing , distribution , prescription ,

and the use of drugs in a society with special

emphasis on the resulting medical , social and

economic consequences”.

AIMS & OBJECTIVES

Description of drug use patterns

Early signals of irrational drug

use

Interventions to improve drug use

Quality control of drug use

Description of drug use patterns Estimating the no: of patients exposed to drugs in a given time

period. Extent of drug use at a certain moment and/or certain area. Extent of drug usage – proper/overuse/underuse Drug use profile – assessing alternative drugs. Comparing observed patterns of drug use to current guide lines. Feed back to prescribers on DU data. Relating the no: of case reports about adverse effects to the no: of

pts exposed to assess the magnitude of the problem.

Early signals of IRRATIONAL DRUG USE

Helps to generate hypotheses for further drug investigations.

Comparing drug utilization patterns and costs b/w different regions or time periods.

Comparing observed patterns of drug use to current recommendations/guidelines.

Interventions to improve drug use Monitoring and evaluating the improvement

measures- information campaigns , regulatory policies.

Following the impact of regulatory changes / changes in insurance/reimbursement systems.

Assessing promotional activities of pharmaceutical industry, educational activities of society’s impact on pattern of drug use.

Quality control of drug usePLAN

Analyse current situation to establish

a plan for improvemen

DOImplement plan on a

small scale

CHECKCheck for the

expected results

ACTRevise or implement plan on large scale

Types of drug information

Drug based information

Problem or encounter-based information

Patient information

Prescriber information

TARGETS Systems and structures surrounding drug use

Processes of drug use Outcomes of drug use

TYPES Quantitative Qualitative1. Cross-sectional study2. Longitudinal3. Continuous longitudinal

TOOLS USED

WHO’s drug use indicators

Drug classification systems

Defined daily systems

Drug Utilization Evaluation OBJECTIVES

1. Ensuring current drug therapy

2. Controlling drug cost

3. Preventing problem related to medication

4. Evaluating the effectiveness of drug therapy

5. Identification of areas of practice that require further education of practitioners

DUE Classification

PROSPECTIVE

CONCURRENT

RETROSPECTIVE

Sources of data on drug utilization1. Large data base

2. Data from drug regulatory agencies

3. Supplier/distribution data

4. Practice setting data

a) Prescribing data

b) Dispensing data

c) Aggregate data

d) OTC & Pharmacist-prescribed drugs

e) Telephone & Internet prescribing

5. Community setting data.

Future Perspectives

1. Public health – diff b/w national & international patterns

of drug utilization requires further study.

2. Pharmacovigilance – DU data can be used to perform

screening pts with ↑ risk for drug induced illnesses.

3. Pharmacoeconomics – by adhering to current guidelines

reduce drug expenditure & improve limited resources.

4. Eco pharmacovigilance – pharmaceuticals are

environmental pollutants care to be taken to ↓

environmental impacts while delivering patient

benefit.

5. Pharmacogenetics – assessing genetic mechanisms

related to drug safety, comparing pts characteristics

to the benefit and risk of drugs.

THANK YOU