La receta médica como instrumento del estudio del consumo de medicamentos en la región de murcia

Abstract

Abstract Objectives Study 1: To estimate the use of cardiovascular medicines and its distribu-tion by age and sex. Study 2: To analyze if reforms concerning the pharmaceutical reimburse-ment scheme in Spain have been associated with changes in the volume and trend of pharmaceutical consumption. Study 3: To describe antibiotic consumption in the Region of Murcia in 2011, within the Spanish and European context, as well as to analyze the dif-ferences within the Region, both between health areas, and between users of the regional health service and those protected by the civil servants&apos; mutual in-surance society (MUFACE). Methodology Study 1: Observational study. Daily doses of cardiovascular drugs pre-scribed and dispensed in all the pharmacies of the Region per 1,000 inhabitans-day (DHD. A comparison was made of consumption rates (DHD) by age and sex. Study 2: Segmented regression analysis of interrupted time-series of pre-scription drug consumption. Study 3: Retrospective observational study of prescriptions dispensed by the pharmacies in the Region of Murcia during 2011. Consumption rates were expressed as defined daily doses (DDD) per 1,000 inhabitants/day and stan-dardized consumption ratios (SCR). Results Study 1: The probability of receiving antiplatelet drugs increases with age, with the proportion of men being higher. The use of beta-blockers and angio-tensin II increases with age up to 79 years, with an increased consumption in men up to 65 years. The probability of receiving treatment with calcium channel blockers, ACE inhibitors or statins, linearly increases with age, and the propor-tion of men under treatment exceeds that of women in the early ages, tending to equalize beyond 80 years. Study 2: Dispensing of all five therapeutic classes fell immediately after co-payment changes. The segmented regression model suggested that per pa-tient drug consumption in pensioners may have decreased by about 6,76% (IC 95% -8,66% a -5,19%) in the twelve months after the reform, compared with the absence of such a policy. Furthermore the slope of the series of consumption increased from 6,08 (p<0,001) to 12,17 (p=0,019). Study 3: Overall antibiotics consumption rate in the Region of Murcia in 2011 was 30.05 DDD/1000/ day, which is much above the average rate for Spain (20.9 DHD) and for the European Union (21.57 DHD). Health areas within the Region with the highest and lowest consumption rate are, respectively, Vega Alta (SCR:124.44; CI95% 124.26 to 124.61) and Cartagena (SCR:84.16; CI95% 84.10 to 84.22). Civil servants covered by the mutual society have higher consumption rates than users of the regional health service (SCR: 105.01; CI95% 104.86 to 105.17). Conclusions Study 1: This study shows that the cardiovascular disease prevention fo-cuses on people aged 40 to 74 years. Access by women to cardiovascular ther-apy occurs with a delay of 3-5 years, depending on the treatment subgroup. Changes should be promoted to encourage rational and equitable access and use of the drugs. Study 2: The implementation of copayment policies could be associated with a significant decreased level in the level of prescribed drug in Murcia Re-gion, but this effect seems to have been only temporary in the five therapeutic groups analyzed, since almost simultaneously there has been an increase in the growth trend. Study 3: There is a high level of antibiotic prescription in the Region of Murcia Region in relative terms. A great variability in antibiotics consumption was observed between the different health areas, which might be related to the higher rate of the frequency of visits. The highest amount of variability in antibi-otics prescription was found in cephalosporins and macrolides. Keywords Cardiovascular agents, pharmacoepidemiology, age groups, gender, drug use, co-payment, time series analysis, antibiotics, pharmacoepidemiology, drug utilization, variability, prescription.