Measuring Medicine Use: Applying ATC/DDD Methodology to Real-World Data

Abstract

Medicines are essential for the treatment of acute, communicable, and non-communicable diseases. The World Health Organization developed a toolkit for drug (medicine) utilization studies to assist in reviewing and evaluating the prescribing, dispensing, and use of medicines. There is a growing need for rigorous studies of medicine use in low- and middle-income countries (LMIC) using standard approaches, especially in the context of universal health coverage. This commentary provides a succinct summary of how to use the WHO anatomical therapeutic chemical (ATC)/ defined daily dose (DDD) methodology in pharmacoepidemiological studies, with a focus on LMIC contexts. We drew on information from WHO resources and published literature, citing examples and case studies. We encourage readers to publish their drug utilization studies, although we caution about predatory journals. We recommend the use of the RECORD-PE initiative which focuses on methods for doing pharmacoepidemiological research and evaluating the quality of published papers.

Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study

“…DDD is a universally accepted metric for drug utilization research ( Hollingworth and Kairuz, 2021 ). Thus, the deviations between PDD and DDD found in this study may be due to the characteristics of ICU patients.…”

Harmonization and standardization of data for a pan-European cohort on SARS- CoV-2 pandemic

“…LOINC played a very important role in defining the SARS-CoV-2 specific laboratory tests referenced in the ORCHESTRA studies’ electronic Case Report Forms (eCRFs); 49 , 50 it was chosen because it is a widely used terminology standard for health measurements, observations, and clinical documents 51 . For variables that aimed at collecting information on medication use, ATC codes were selected using the WHO’s ATC/DDD Index 2021 52 . Data that provided genetic, epigenetic, and sequencing information were generally assigned codes chosen through the use of the NCI Term Browser 53 .…”

Trends in consumption and use of antidepressants and benzodiazepines in the Republic of Serbia in the period 2006-2019

“…Ова статистичка вредност сугерише колико је становника (од њих 1000) користило одређени лек и колико је било изложено деловању лека свакога дана. На пример, вредност од 10 DDD/1000/дан означава просечну употребу од 10 DDD на 1000 становника свакога дана у току године; другим речима, 1% популације је користио дефинисану дозу свакодневно [14].…”

“…This statistical value indicates how many people (out of 1000) used a certain medicine and how much they were exposed to the action of the medicine every day. For example, a value of 10 DDD / 1000 / day means an average use of 10 DDD per 1000 inhabitants every day during the year; in other words, 1% of the population used a defined dose every day [14].…”