Utilization of Parenteral Morphine by Application of ATC/DDD Methodology: Retrospective Study in the Referral Teaching Hospital

Dragojević-Simić, Viktorija; Rančić, Nemanja; Stamenković, Dušica; Simić, Radoje

doi:10.3389/fpubh.2017.00232

Cited by 7 publications

(10 citation statements)

References 24 publications

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“…The data on the metamizole and other groups of non-opioid analgesics utilization was analyzed according to the Anatomical Therapeutic Chemical/Defined Daily Doses (ATC/DDD) methodology ( 2 , 13 , 24 ). Results were expressed as the number of defined daily doses per 1,000 inhabitants per day (DDD/1000 inhabitants/day) ( 25 , 26 ).…”

Section: Methodsmentioning

confidence: 99%

Metamizole Utilization and Expenditure During 6-Year Period: Serbia vs. Croatia

Miljković

Dragojević-Simić

Rančić

et al. 2018

Front. Public Health

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Background: Metamizole is a medication with analgesic, antipyretic, spasmolytic, and weak anti-inflammatory effects. The aim of our study was to evaluate a six-year trend in the utilization and expenditure of metamizole in comparison to other group of licensed non-opioid analgesics in Serbia and Croatia, in order to rationalize its use and prescribing in these countries.Methods: The data of metamizole vs. all other non-opioid analgesics utilization and expenditure in Serbia and Croatia was analyzed according to the WHO methodology and expressed as defined daily doses per 1,000 inhabitants per day (DDD/1,000 inhabitants/per day) and total costs, respectively, during the 6-year period from 2010 to 2015.Results: In the observed period, utilization of metamizole was 3.31 fold higher in Serbia than in Croatia (median in Serbia was 2.238 vs. 0.675 in Croatia DDD/1,000 inhabitants/per day/per year). Expenditure of metamizole in the same period was 5.29-fold higher in Serbia than in Croatia (median in Serbia was 1,738,192.51 €/per year vs. 328,355.03 €/per year in Croatia).Conclusion: Utilization and expenditure of non-opioid analgesics, including metamizole, in Serbia was significantly higher comparing with Croatia.Further research is needed to determine whether the current analgesic consumption in Serbia meets the needs of the patient. The benefits of metamizole should be weighed against the risk of metamizole-induced adverse effects. Until then, its prescribing should be based on indications and the appropriate duration of therapy.

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Section: Methodsmentioning

confidence: 99%

Metamizole Utilization and Expenditure During 6-Year Period: Serbia vs. Croatia

Miljković

Dragojević-Simić

Rančić

et al. 2018

Front. Public Health

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“…In 2016 morphine consumption in Serbia was 12.52; 12.58 and 15.9 times lower than in Sweden, Norway and European Union, respectively, while this difference concerning Montenegro in the same period was even more prominent 20 . In our previous study concerning utilization of parenteral morphine in the tertiary care hospital, low level of morphine use was demonstrated in comparison to other European country 31 , and one of the reasons was low marketing price connected with no-brand names. Moreover, better education and training of staff and multidisciplinary approach should enable more rational use of opioids, not only in the hospital.…”

Section: Discussionmentioning

confidence: 93%

Costs and consumption of analgesics, with special reference to opiates in Serbia and Montenegro from 2015 to 2019

et al. 2022

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Background/Aim: Patients in developing countries do not always receive adequate painrelieving treatment. Monitoring of analgesic consumption is of great importance, since this can help assessing the quality of painful condition management. The aim of this paper is to present a five-year consumption and costs of drugs with analgesic effects in developing countries, exemplified by Serbia and Montenegro, and indicate the main reasons for their (in)adequate prescribing. Methods: The observational, retrospective, cross-sectional study was conducted in order to analyse consumption of all analgesics, both opioid and non-opioid, in Serbia and Montenegro, as developing countries. The data concerning analgesic consumption and drug prices were obtained from annual editions of the publications of the Medicines and Medical Devices Agency of Serbia and Montenegro. The WHO methodology with defined daily dose (DDD) as a unit of measure (it is defined by the number of DDD per 1000 inhabitants per day) was used in these publications. Results: In the course of the fiveyear period (from 2015 to 2019) in Serbia, the total allocations for analgesic therapy had a rising trend; from about 43.6 million to 63.3 million of Euros, while in Montenegro expenditures showed annual variations with highest value in 2018. Most of the money in both countries was invested in M01A group of drugs, for which the highest consumption was also recorded. Significantly higher consumption of opioid analgesics in Montenegro comparing with Serbia was observed in the same period, and it predominatly reflected the difference in fentanyl (N02AB03, transdermal patch) prescribing. In Montenegro, consumption of M01group of drugs was prominently higher in comparison to M01AE group during the whole five-year period, similarly like in Serbia in which this was not the case only in 2018. Conclusions: Taking into account the importance of analgesics for everyday medical practice, more rational prescribing of these drugs is necessary both in Serbia and Montenegro in the future.

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“…To compare drug use at a general level, the WHO has adopted Anatomical Therapeutic Chemical (ATC) and defined daily dose (DDD) system [ 17 ] referred to as the ATC/DDD system. DDD is defined as the average daily dose of adults used for therapeutic purposes [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Cross-sectional study on the drug utilization and evaluation indicator of antibiotics used in pediatric population

Zhang

Wang

et al. 2021

BMC Health Serv Res

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Background The lack of medication standards is a serious problem in paediatrics mainly because of age-related differences in organ development and physiological functions in children. Consequently, dosage measurement becomes inaccurate. For this reason, methods for evaluating and monitoring rational paediatric medications should be developed. Drug use indicators, such as those similar to the drug utilisation index (DUI) based on the Anatomical Therapeutic Chemical/Defined Daily Dose (DDD) and widely used for the assessment of appropriate dosage in adults, should be explored in terms of their applicability to children. Methods A total of 5,538 prescriptions of antibiotics selected from a general teaching hospital were included. Drug, dose, frequency and treatment duration were obtained from each prescription. The prescription daily dose (PDD) of each antibiotic drug was calculated as the average of the daily doses. Underdose and overdose were determined in terms of the PDD/DDD ratio for each prescription. Children’s DUI (cDUI) was explored in terms of the appropriate dosage for children as follows: the meaning of children’s DDD (cDDD) and the evaluation of paediatric drug dosage. Results The top five antibiotics and their utilisation rates were as follows: cefmetazole sodium injection (18.47 %), erythromycin lactobionate injection (15.07 %), amoxicillin/clavulanate potassium injection (10.72 %), ceftriaxone sodium injection (9.50 %) and azithromycin dry suspension (8.02 %). The ratio of cDUI and PDD/cDDD was mostly not close to 1. Conclusions The establishment of a cDUI system is an effective means of paediatric dosage evaluation. In addition to DDDs, cDUI and PDD/cDDD should be used to analyse the utilisation of antibiotics in children.

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Utilization of Parenteral Morphine by Application of ATC/DDD Methodology: Retrospective Study in the Referral Teaching Hospital

Cited by 7 publications

References 24 publications

Metamizole Utilization and Expenditure During 6-Year Period: Serbia vs. Croatia

Metamizole Utilization and Expenditure During 6-Year Period: Serbia vs. Croatia

Costs and consumption of analgesics, with special reference to opiates in Serbia and Montenegro from 2015 to 2019

Cross-sectional study on the drug utilization and evaluation indicator of antibiotics used in pediatric population

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