Determinants of the drug utilization profile in the paediatric population in Italy's Lombardy Region

Abstract

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Drug utilization studies performed in the Italian paediatric population have found a prescription profile that appears to be specific to Italy. • Quantitative and qualitative differences with other European countries have been found. • The prevalence of drug prescription is higher in southern Italy compared with northern Italy. WHAT THIS STUDY ADDS • This is the first study to evaluate the geographical differences in the pattern of drug prescribing to children and adolescents in a large Italian region. • Large differences in the prescription prevalence rate were found between local health units. • Living in the eastern part of the Lombardy region is associated with the highest risk of drug exposure. AIMS To evaluate the intraregional differences in drug prescribing to children and adolescents. METHODS Prescriptions reimbursed by the National Health System, involving 1543 203 children and adolescents <18 years old and dispensed during 2005 by the retail pharmacies of 15 local health units (LHU) in the Lombardy Region, were analysed. Logistic regression analysis was performed to evaluate the association between drug prescription and age, gender, prescriber, and setting. RESULTS A total of 747 790 youths (48%) received at least one drug prescription. The prescription prevalence rate was highest in children 1–5 years old (65%), decreased with increasing age to 38% in adolescents, and was slightly higher in boys than in girls. Antibiotics and anti‐asthmatics were the most prescribed therapeutic classes. Amoxicillin + clavulanic acid was the most prescribed drug (18% of children; 20% of packages). Large differences were found in the drug prescription prevalence rate between the different LHUs. The rate ranged between 38.4 and 54.8%, and was not correlated to hospitalization rate in the paediatric population. Being 1–5 years old [odds ratio (OR) 4.51, 95% confidence interval (CI) 4.43, 4.58] and living in the eastern part of the region (OR 2.06, 95% CI 1.99, 2.13) were the factors associated with the highest risk of drug exposure. CONCLUSIONS The results resemble the profiles observed in other Italian contexts, in particular concerning the wide use of antibiotics and anti‐asthmatics. However, large differences were found between LHUs, highlighting the need for more detailed investigations on therapeutic needs, drug use, and related variables in different geographic contexts.

Factors associated to medicine use among children from the 2004 Pelotas Birth Cohort (Brazil)

“…Similar results were found in a 2005 Italian study (Lombardia) reporting a prevalence of 65% among children from 12 months to fi ve years of age. 15 In the 1982 Pelotas Birth Cohort, the prevalence of medicine use was 56% in children aged 35 to 53 months. 9 Medicine use throughout the life course shows a J-shaped distribution, that is, higher prevalence during early life, decreasing during adolescence and gradually increasing in adult life with the highest prevalences seen among the elderly.…”

“…16 Medicine use in children are associated to sociodemographic characteristics, health insurance status, child's age younger than fi ve, medical visits in the past days, mothers' perception of their child's health and health conditions. 12,15,21 The present study aimed to identify factors associated to medicine use among children from the 2004 Pelotas Birth Cohort, Brazil.…”

Off-label antibiotic use in children in three European countries

“…The drugs most frequently prescribed for children are antibiotics [27,28], most of which lack patent protection. The aim of the present study was to evaluate off-label antibiotic use in three European countries.…”

The Determination of the Factors Affecting Pharmaceutical Consumption in Respect to Provinces in Turkey

“…In the recent studies, the factors affecting pharmaceutical consumption of the people staying at nursing homes in Belgium (Elseviers et al, 2010), the factors affecting pharmaceutical consumption in Spain with multinominal logistic regression (Jiménez-Rubio and Hernández-Quevedo, 2010), the waste and consumption of pharmaceutical of people in Jordan (Abushanab et al, 2013), pharmaceutical expenses and the determinants of pharmaceutical consumption of the people living in Catalonia (Costa-Font et al, 2007), the factors affecting the pharmaceutical consumption of pediatric population between 0 and 17 years-old (Clavenna et al, 2009), socio-demographic factors affecting pharmaceutical consumption in Greece (Pappa et al, 2006), financial burden of pharmaceutical consumption to people and public in Poland ( uczak and García-Gómez, 2012) and health expenses in 1992 and 2000 in France have been examined comparatively to the data obtained by questionnaires (Dormont et al 2006).…”

“…In the recent studies, it has been found out that variables such as gender (Costa-Font et al, 2007;Tahmasebi et al 2013;Jiménez-Rubio and Hernández-Quevedo, 2010), age (Clavenna et al, 2009;Tahmasebi et al, 2013;Jiménez-Rubio and Hernández-Quevedo, 2010), the level of income (Costa-Font et al, 2007;Abushanab et al, 2013), region (Clavenna et al, 2009), the state of disease (Costa-Font et al, 2007), private health insurance (Jiménez-Rubio and Hernández-Quevedo, 2010), the use of cigarettes and alcohol (Jiménez-Rubio and Hernández-Quevedo, 2010) and the behavior of doctors (Lambrelli and O'Donnell, 2011) have positive effect on pharmaceutical consumption. It has been determined in some studies that there is a positive relation between life expectancy and pharmaceutical consumption (Grandfils et al, 2009;Miller and French, 2000;Shaw et al, 2005;Frech and Richard, 2004;Caliskan, 2009).…”