title: [Prescription appropriateness: Indication of citicoline in Primary Care].
abstract: BACKGROUND
  The economic situation has made it necessary to optimize resources by adjusting the pharmaceutical expenditure. Citicoline was (2011) the 10th drug by rank of billed amount. Its approved indications are stroke (acute and sub-acute) and head injury, but not cognitive decline associated with age, the presumed indication for most of its use.
  
  
  OBJECTIVE
  To assess the conditions of use of citicoline in the Health Area of Tenerife, in order to detect deviations from the indications of use as stipulated in the prescribing information sheet and the pattern of prescription, with emphasis on the analysis of its use in dementia where currently it has no indication or evidence to support it.
  
  
  METHODS
  Cross-sectional study of prescription-indication. A 680 patient sample, segmented by reference hospital (error±5%; CI: 0.95%; P=0.5) was taken from the 4036 patients with a prescription of citicoline billed during august-october 2011 (obtained from the prescription database program, Farmacanarias).
  
  
  RESULTS
  We found that 123 patients (18.1%) had an appropriate indication. By including the prescription regimen, 28 patients (4.1%) had adequate indication and dose levels, and in only 2 patients (0.2%) an appropriate indication, dosage and duration were found.
  
  
  CONCLUSIONS
  "The correct prescription-indication" of citicoline is inappropiate in almost all patients studied. Impact actions are needed in order to optimize prescription, improve patient safety by reducing potential interactions, and the occurrence of adverse effects, and improve efficiency by promoting savings.
authors.affiliation: Departamento de Farmacia, Gerencia de Atención Primaria, Área de Salud de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España. Electronic address: apadluz@gobiernodecanarias.org.
authors.forename: A
authors.initials: A
authors.lastname: Padilla Luz
authors.affiliation: Área Técnica de Salud Pública, Gerencia de Atención Primaria, Área de Salud de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España.
authors.forename: J F
authors.initials: JF
authors.lastname: Reyes Rodríguez
authors.affiliation: Departamento de Farmacia, Gerencia de Atención Primaria, Área de Salud de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España.
authors.forename: A
authors.initials: A
authors.lastname: Gómez Rodríguez de Acuña
authors.affiliation: Departamento de Farmacia, Gerencia de Atención Primaria, Área de Salud de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España.
authors.forename: C M
authors.initials: CM
authors.lastname: González Gómez
authors.affiliation: Departamento de Farmacia, Gerencia de Atención Primaria, Área de Salud de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España.
authors.forename: I
authors.initials: I
authors.lastname: Álvarez Dorta
authors.affiliation: Dirección Médica, Gerencia de Atención Primaria, Área de Salud de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España.
authors.forename: M E
authors.initials: ME
authors.lastname: Pérez Cánovas
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003566:Cytidine Diphosphate Choline / Q000008:administration & dosage / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D018697:Nootropic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D011320:Primary Health Care; D013030:Spain
chemical_list: D018697:Nootropic Agents; D003566:Cytidine Diphosphate Choline
keywords: Citicolina; Citicoline; Financial resources in health; Inadequate prescription; Prescripción inadecuada; Recursos financieros en salud