Theoretical exposure of chronically treated patients to lipid lowering agents.
OBJECTIVE
The objective was to analyse the exposure to lipid lowering agents (LLA) using the databases of health insurance companies and to appraise its concordance with the findings of evidence based medicine.


METHODS
Three health insurance companies' prescription based databases were analysed in the years 1997-2000. All inhabitants in the Czech Republic (CR) have to be insured. The insured person with a recorded prescription for LLA in the year of interest was defined as a patient, the insured person with a recorded prescription for LLA in the years bordering the year of interest was defined as a chronically treated patient. In the year of interest the percentage of chronically treated patients without LLA medication, with 'very low' (<122 defined daily doses (DDD)/year), 'low' (122-243 DDD/year) and 'adequate' (>243 DDD/year) consumption was determined.


RESULTS
During the observed period the total consumption of LLA increased among 450 000 inhabitants twice (by 109.6%) to 24.8 DDD/1000 inhabitants/day. In 2000 the rate of the consumption of statins and fibrates represented 34.2 and 65.6% respectively. In 1998 33.5% and in 1999 41.0% of the chronically treated patients occurred in the 'adequate' consumption group.


CONCLUSIONS
The signals of inappropriate drug treatment such as the preferred use of fibrates and low doses of LLA prescribed to the Czech population were identified. Conversely, the increasing proportion of the chronically treated patients belonging to the group with the 'adequate' consumption could be considered as a positive signal.
Kucera
Zdenek
Z
Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Kralove, Czech Republic. kucera@faf.cuni.cz
Vlcek
Jiri
J
Hejdova
Miroslava
M
D000367:Age Factors; D018153:Czech Republic / Q000453:epidemiology; D003625:Data Collection / Q000379:methods; D004334:Drug Administration Schedule; D017723:Drug Utilization Review / Q000379:methods / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine / Q000379:methods; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000145:classification / Q000494:pharmacology* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017891:Pharmacoepidemiology / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends; D012737:Sex Factors; D013997:Time Factors
D000960:Hypolipidemic Agents