Pharmacoepidemiology and drug safety
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Pharmacoepidemiol Drug Saf · Apr 2007
Trends in the use of antihypertensive drugs by outpatients with diabetes in Taiwan, 1997-2003.
To analyze trends in AHD-use by diabetic outpatients in Taiwan over a 7-year period (1997-2003) and to see whether the trends are consistent with clinical trial outcomes and published guidelines. ⋯ The use of drugs acting on the RAS showed a marked increasing trend over the course of the study. Physicians' prescribing patterns for AHD are increasingly involving multi-drug regimens. These findings may imply that management of hypertension in patients with diabetes had a positive trend toward to new clinical trial outcomes and guideline's recommendation.
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Pharmacoepidemiol Drug Saf · Mar 2007
Measurement of changes in antihypertensive drug utilisation following primary care educational interventions.
To measure changes in drug utilisation following a national general practice education program aimed at improving prescribing for hypertension. ⋯ A national education program aimed at GPs was successful in improving prescribing for hypertension. Lessons learned will be applied in evaluation of future NPS programs and are also applicable to analysis of other interventions aimed at influencing prescribing behaviour.
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Iatrogenic injury from adverse drug events (ADEs) is a common and often preventable problem in modern medical practice. Attention to this problem has focused on the inpatient hospital setting and healthcare professionals. However, most medication is prescribed and used outside of hospitals and is managed by patients or lay caregivers in homes or workplaces. ⋯ First, Haddon's phase-factor matrix can be used to help conceptualize outpatient drug safety interventions. Second, interventions to improve outpatient drug safety should be patient-centered and extend beyond patient education to include engineering innovations and enforcement strategies. Third, the sustainability of active versus passive interventions should be considered when choosing safety interventions.
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Pharmacoepidemiol Drug Saf · Dec 2006
Comparative StudyUse of cyclo-oxygenase 2 inhibitors (COX-2) and prescription non-steroidal anti-inflammatory drugs (NSAIDS) in UK and USA populations. Implications for COX-2 cardiovascular profile.
COX-2 and NSAIDS differ in their gastrointestinal (GI) and cardiovascular (CV) toxicity from pharmacological, clinical and epidemiologic point of views. ⋯ Our results confirm some previous findings from other authors such as the presence of both GI and CV channelling to COX-2 agents but refute others, such as the frequency of drug switching between these agents. The typical use of COX-2 agents in practice is for shorter duration, and at lower doses, than was employed in randomized clinical trials. This difference may help clarify the apparent discrepancy with respect to CV toxicity between the results from clinical trials, which showed a higher CV risk with these drugs, and non-experimental epidemiologic studies, which showed lower or no increase in risk.