Usage of the claim database of national health insurance programme for analysis of cisapride-erythromycin co-medication in Taiwan.
OBJECTIVE
This study aimed to use the National Health Insurance Research Database, Taiwan for risk analysis of concomitant use of cisapride and erythromycin.


METHODS
The sample consisted of subjects identified in the Outpatient Sampling Database (OSD) and Longitudinal Health Insurance Database 2000 (LHID 2000), derived from the original claim data of the National Health Insurance Research Database, Taiwan.


RESULTS
According to the LHID 2000, a total of 464 individuals experienced 685 episodes of cisapride-erythromycin co-medication prescribed by 295 physicians, revealing a prevalence of 4.5% concomitant use, with higher prevalence in clinics (9.2%) than in other medical institutes (3.7-5.4%). Among the co-medication episodes, 81.9% and 61.2% were prescribed from the same health institutes and by the same physicians, respectively. No medical record of cardiac arrhythmias was found among these patients in 2001 and 2002, probably due to the fact that 78.9% of the 464 individuals were under age 16, 84.0% had short exposure duration (1-4 days) and 98.0% of the episodes were prescribed with a cisapride dose of less than 0.8 mg/kg/day.


CONCLUSIONS
Findings from this study suggest that there exists an urgent need for accreditation in terms of pharmacovigilance of clinical sites and their practicing physicians for the prevention of irrational concomitant prescription in Taiwan. Our findings also indicate that it is necessary to investigate other possible conditions of potentially dangerous co-medication in Taiwan and other developing countries.
Gau
Churn-Shiouh
CS
School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chang
I-Shou
IS
Lin Wu
Fe-Lin
FL
Yu
Hui-Tzu
HT
Huang
Yu-Wen
YW
Chi
Cheng-Liang
CL
Chien
Su-Yu
SY
Lin
Keh-Ming
KM
Liu
Ming-Ying
MY
Wang
Hui-Po
HP
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D020117:Cisapride / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016208:Databases, Factual; D004305:Dose-Response Relationship, Drug; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D004917:Erythromycin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006331:Heart Diseases / Q000139:chemically induced / Q000175:diagnosis; D006801:Humans; D007223:Infant; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D007356:Insurance, Pharmaceutical Services / Q000706:statistics & numerical data; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D011014:Pneumonia / Q000139:chemically induced / Q000175:diagnosis; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011358:Product Surveillance, Postmarketing / Q000379:methods / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods; D013624:Taiwan
D005765:Gastrointestinal Agents; D004917:Erythromycin; D020117:Cisapride