Patterns of respiratory drug use in the Lombardy region of Italy, 1995-1997.
OBJECTIVE
To examine the patterns of respiratory drugs use in the Lombardy region of Italy, and to quantify the period prevalence of different drug-dose combinations defined by reference to international guidelines for prescription in asthma and chronic obstructive pulmonary disease.


METHODS
Analysis of records from an anonymised population-based database of dispensed prescriptions.


METHODS
Lombardy, 1995-1997.


METHODS
Analyses were made of prescription records of patients who had at least one respiratory drug dispensed during the study period. Prescriptions for the same individual were linked using a unique identifier.


RESULTS
Number of patients using respiratory drugs; number of visits to the pharmacy; defined daily doses.


RESULTS
1,387,004 or 15.5% of the resident Lombardy population had at least one dispensed prescription of a respiratory drug in the three years of study. The annual percentage increased from 6.6% in 1995 to 7.9% in 1997. 808,786 patients (58.3% of respiratory drug users) had only one visit to the pharmacy during this period, while the 25.1% of respiratory drug-user (3.9% of the resident population) who had three or more visits to the pharmacy in three years, accounted for 86.1% of all respiratory drug use in terms of defined daily doses. When combinations of prescribed drugs were examined in the light of published guidelines, we estimated that <2.8%> of the population had patterns of drug prescription appropriate for mild intermittent or persistent forms of asthma/chronic obstructive pulmonary disease, and <1.1%> had prescription patterns appropriate for moderate or severe disease.


CONCLUSIONS
The definition of specific drug use patterns by individual can provide prevalence measures that are broad proxies for varying categories of respiratory disease. However, a very high proportion of people who receive respiratory drugs do so for one-off or very infrequent episodes of illness. Analysis of the infrequent and more regular users of respiratory drugs may be useful for comparative research.
Vegni
Ferdinando E
FE
Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK. ferdinando.vegni@lshtm.ac.uk
Wilkinson
Paul
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy; D008297:Male; D008875:Middle Aged; D017891:Pharmacoepidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D019141:Respiratory System Agents / Q000008:administration & dosage* / Q000627:therapeutic use
D018927:Anti-Asthmatic Agents; D019141:Respiratory System Agents