Pharmacoepidemiology and drug safety
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Pharmacoepidemiol Drug Saf · Apr 2013
Risk of upper gastrointestinal complications in a cohort of users of nimesulide and other nonsteroidal anti-inflammatory drugs in Friuli Venezia Giulia, Italy.
Information on the risk of upper gastrointestinal complications (UGIC) in users of nimesulide, the most used nonsteroidal anti-inflammatory drug (NSAID) in Italy, is scarce. In the context of the European regulatory review on nimesulide, we estimated and compared the risk associated with nimesulide and other individual NSAIDs with the risk in nonusers. ⋯ IRs of UGIC in FVG decreased about 50% between 2001 and 2008. Nimesulide was in the low-medium range of RR. A complete ascertainment of UGIC cases in databases may require validation of nonspecific codes, secondary codes, and additional codes such as peritonitis and acute posthemorrhagic anemia.
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Pharmacoepidemiol Drug Saf · Apr 2013
High correlations between levels of consumption and mortality related to strong prescription opioid analgesics in British Columbia and Ontario, 2005-2009.
Prescription opioid analgesic (POA)-related burden of disease - including mortality - is high and constitutes a major public health problem in the US and Canada. Associations between the overall levels of POA consumption and key related morbidity indicators in the population have been demonstrated. We examined potential correlations between levels of consumption of four commonly used POAs and related mortality in British Columbia (BC) and Ontario. ⋯ Our findings of strong correlations between select POA use and mortality levels reflect similar evidence from elsewhere on correlations between POA consumption and morbidity or mortality indicators. In the context of high and increasing levels of POA consumption in Canada, efforts to reduce POA-related mortality may require a comprehensively revised approach towards more appropriate and safer prescribing to reduce POA use volumes together with more effective monitoring of POA medications.
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Pharmacoepidemiol Drug Saf · Apr 2013
Frequency and nature of drug-drug interactions in the intensive care unit.
Drug-drug interactions (DDIs) may compromise patient safety. However, there are no good estimates of their frequency or understanding of their nature in the intensive care unit (ICU). The objective of this study was to determine the frequency and nature of potential DDIs (pDDIs) in the ICU when assessed in light of documented and perceived clinical relevance. ⋯ There are many potential DDIs with high perceived relevance in the ICU that appear to require attention and follow-up. Computerized decision support may help reduce the number of pDDIs but needs to be tailored to the environment in which it operates.