Épidémiologie, santé publique et bases de données médico-tarifaires

Fender, P; Weill, Alain

doi:10.1016/s0398-7620(04)99032-3

Cited by 18 publications

(4 citation statements)

References 4 publications

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“…The regional fund that is part of the national health insurance system [16] provided a dataset containing records of all analgesics that had been dispensed during that period to patients covered by the general health insurance scheme (i.e. 80% of the regional population).…”

Section: Methodsmentioning

confidence: 99%

Use of analgesics in France, following dextropropoxyphene withdrawal

Ganse

Belhassen

Ginoux

et al. 2018

BMC Health Serv Res

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BackgroundIn 2009, the European Medicines Agency recommended withdrawal of dextropropoxyphene (DXP); in March 2011 it was withdrawn from the market in France. Up until that time the combination dextropropoxyphene-paracetamol (DXP/PC) was widely used for analgesia. At withdrawal, French regulators recommended that DXP/PC be replaced by other step 2 analgesics, i.e. tramadol, codeine, or opium-containing drugs, or by PC for a weak level of pain. To investigate prescribing behaviours after DXP/PC withdrawal, dispensations of analgesics before and after withdrawal were analysed.MethodsAggregated dispensation data of analgesics prescribed between January 2009 and December 2012 in the Rhône-Alpes region were obtained from the general health insurance claims data; changes in analgesic dispensation over time were analysed with the ATC/DDD methodology. Pre (Jan-June 2009) and post-withdrawal (Jan-June 2012) changes of DDDs where computed for each analgesic step.ResultsThe dispensations of DXP/PC experienced a two-step decrease until 2011. Over the withdrawal period 2009-2012, there was a 14% decrease in the overall use of analgesic (from 109 to 94 DDDs), while the use of step 2 analgesics declined by 46% (− 22 DDDs, from 47 to 25 DDDs). This latter decline included a cessation of use of DXP/PC (29 DDDs in 2009) that were only in part (+ 7 DDDs, from 18 to 25 DDDs) compensated by increased use of codeine, tramadol and opium, in monotherapy or combined with PC. For step 1 analgesics, use increased with 9%, mostly PC (+ 8 DDDs, from 31 to 39 DDDs). Step 3 analgesics dispensations remained largely unchanged over this period (around 3 DDDs).ConclusionsIn the Rhône-Alpes region, DXP/PC withdrawal was accompanied in part by an increased use of same level analgesics, and in part by an increased use of PC in monotherapy. The extent of DXP/PC use before withdrawal, and the increased use of PC after DXP withdrawal, underline the complexity of pain management.

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Section: Methodsmentioning

confidence: 99%

Use of analgesics in France, following dextropropoxyphene withdrawal

Ganse

Belhassen

Ginoux

et al. 2018

BMC Health Serv Res

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“…The level of confidence in our register was assessed for children born in 1985–1993; it varied between 80% and 87%, which can be considered fairly good,11 and there was no significant trend over time. Large national databases, constructed for health economy purposes (eg, DRG (diagnosis-related group, a system to classify hospital cases into one of approximately 500 groups), social insurance) are not very helpful when studying rare diseases 12. The overall prevalence rate of rare diseases is probably higher, as most become apparent later in life.…”

Section: Discussionmentioning

confidence: 99%

Rare diseases in disabled children: an epidemiological survey

et al. 2007

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“…Administrative claims data were provided by the regional reimbursement database (Extraction, Recherches, Analyses pour un Suivi Medico-Economique, ERASME). This database contains information on all reimbursement data for patients affiliated to the main French NHI living in the Rhône-Alpes area, including drugs and hospitalizations ordered by physicians, for the previous 24-month period 15. We focused on ten therapeutic classes as follows (drug names are presented in Table S1): drugs for obstructive airways disease (ie, beta-2-adrenoreceptor agonist or glucocorticoid aerosol), mucolytics (dornase alfa), inhaled anti-infectives (ie, colistin or tobramycin), oral anti-infectives (ie, azithromycin or itraconazole), CFTR potentiator (ivafactor), drugs for acid-related disorders, digestive enzymes (lipase and protease), bile acids, vitamins and mineral supplements (ie, calcium or tocopherol), and antidiabetics (insulin and oral hypoglycaemic drugs such as repaglinide).…”

Section: Methodsmentioning

confidence: 99%

<p>Adherence to long-term therapies in cystic fibrosis: a French cross-sectional study linking prescribing, dispensing, and hospitalization data</p>

Rouzé

Viprey

Allemann

et al. 2019

PPA

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Background Cystic fibrosis (CF) is a life-shortening genetic condition that usually affects several organs and involves significant treatment burden. Adherence to medication is important for successful CF management. Objective To describe medication adherence according to age, therapeutic class, and pharmaceutical form in adults and children followed in four regional CF centers in France. Methods We conducted a cross-sectional study with non-transplanted patients followed in two adult and two pediatric centers during 2015 who were covered by the French National Health Insurance (NHI). Sociodemographic, clinical, hospitalization, and prescription data were collected from patient medical records. Medication dispensations were extracted from the regional French NHI database. Adherence was calculated over 12 months using continuous medication availability (CMA) accounting for dose adjustments and hospitalizations. Drug-specific CMA was computed in R with the AdhereR package for each medication prescribed more than 3 months, which was averaged to obtain a composite CMA score (cCMA) for all treatments and per therapeutic class as well as pharmaceutical form for each patient. Results A total of 228 patients were included. The number of chronic medications increased with age ( r =0.50, p <0.001): a median of 7 medications per patient were prescribed. The mean±SD cCMA was significantly different between age groups ( p =0.0098): it was 0.71±0.20 for the 0–5 years age group, 0.73±0.16 for 6–11 years, 0.64±0.17 for 12–17 years, 0.57±0.23 for 18–25 years, and 0.65±0.20 for the over 25 years age group. cCMA varied significantly according to pharmaceutical forms: the mean±SD cCMA was 0.70±0.21 for oral medications and 0.54±0.28 for inhaled medications ( p <0.001). Conclusion This study suggests that adherence to medication regimens in CF patients remains suboptimal and varies substantially between age groups and pharmaceutical forms. These variations in adherence should be considered when developing effective strategies to improve adherence.

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Épidémiologie, santé publique et bases de données médico-tarifaires

Cited by 18 publications

References 4 publications

Use of analgesics in France, following dextropropoxyphene withdrawal

Use of analgesics in France, following dextropropoxyphene withdrawal

Rare diseases in disabled children: an epidemiological survey

<p>Adherence to long-term therapies in cystic fibrosis: a French cross-sectional study linking prescribing, dispensing, and hospitalization data</p>

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