Utilization of cardiovascular drugs in Zagreb 2001-2005.
OBJECTIVE
The purpose of this study was to investigate the outpatient utilization of cardiovascular drugs in Croatia, during the period 2001-2005, using the Anatomical Therapeutic Chemical classification of drugs/Defined Daily Dose (ATC/DDD) methodology.


RESULTS
Data on outpatient drug utilization were obtained from the Zagreb Municipal Pharmacy to calculate the number of defined daily dose (DDD), and DDD per 1000 inhabitants per day (DDD/1000/day). The drug utilization 90% (DU90%) method was used on drug prescribing quality assessment. Data on hospital admissions were collected from the inpatient database kept at the Zagreb Institute of Public Health. Total utilization of cardiovascular drugs (ATC group C), was between 402.9 Defined Daily Dose per 1000 inhabitants per day (DDD/TID) and 362.9 DDD/TID in Croatia between 2001 and 2005. Agents acting on the renin-angiotensin system (C09) (104.2 DDD/TID) and calcium channel blockers (C08) (80.5 DDD/TID) accounted for more than 50% of drugs used for the treatment of hypertension in 2005. A great increase in the utilization was observed for statins (78.3%). A markedly increasing utilization was recorded for angiotensin-converting enzyme (ACE) inhibitors in combination with hydrochlorothiazide (HCTZ) (40.5%) and angiotensin II antagonists (278%). Comparison of the DU90% segment between 2001 and 2005 revealed pentoxifylline and amiodarone to be absent, whereas cilazapril and ramipril in combination with HCTZ, bisoprolol, valsartan and losartan alone or in combination with HCTZ were added in 2004 and 2005. The total rate of hospital admissions for major cardiovascular events decreased by 18.2%.


CONCLUSIONS
The utilization pattern was improved in 2005, showing a decrease in the number of hospital admissions for major cardiovascular events.
Stimac
Danijela
D
Department of Health Promotion, Dr. Andrija Stampar Institute of Public Health, Zagreb, Croatia. danijela.stimac@stampar.hr
Polić-Vizintin
Marina
M
Skes
Marija
M
Cattunar
Albert
A
Cerović
Robert
R
Stojanović
Drazen
D
D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D002121:Calcium Channel Blockers / Q000008:administration & dosage; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D017523:Croatia / Q000453:epidemiology; D016208:Databases, Factual; D004232:Diuretics / Q000008:administration & dosage; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D007297:Inpatients / Q000706:statistics & numerical data*; D010045:Outpatients / Q000706:statistics & numerical data*; D010594:Pharmacies / Q000706:statistics & numerical data; D012084:Renin-Angiotensin System / Q000187:drug effects; D012189:Retrospective Studies
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D002317:Cardiovascular Agents; D004232:Diuretics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors