INTRODUCTION: Inpatient pharmacoepidemiological research is lacking in Slovenia, especially in psychiatric hospitals.
AIM: The main aim of this thesis is to present medicine consumption trends at the Psychiatric Hospital Ormož from 2014 to 2018 and to set measures for optimization of medication use.
METHODS: In this pharmacoepidemiological study, we have examined trends of medicines consumption at the Psychiatric hospital Ormož in the period from 2014 to 2018 and compared them with outpatient medicine use in Slovenia. The medication consumption was presented with ATC classification in the number of consumed defined daily doses (DDDs) per year, DDDs per patient, per 100 patients and per 100 hospital bed-days (ATC/DDD methodology). The clinical meaning of this research was interpreted using current treatment guidelines and scientific articles. The research included the most clinically interesting, most common and most financially important groups of medicines according to the ATC classification.
RESULTS AND DISCUSSION: Consumption of proton pump inhibitors is increasing and therefore, more control over prescribing including clinical pharmacist interventions is suggested. Consumption of cardiac agents is low and fluctuates and a positive trend is shown by low cardiac glycosides consumption. Low consumption of alpha-blockers is a positive finding. A positive finding among beta blocking agents is the high consumption of bisoprolol and the low consumption of non-selective beta blocking agents, which is in line with current recommendations. Amlodipine has the highest consumption between calcium channel blockers, which is in line with outpatient trends, where the consumption of verapamil is declining. The use of medicines acting on the renin–angiotensin system is high, especially in terms of ACE inhibitors, which is in line with the latest guidelines. Antibiotic prescribing is stable and rational. The consumption of nonsteroidal anti-inflammatory drugs suggests possibilities for optimising prescribing patterns, including clinical pharmacist interventions. The consumption of analgesics indicates appropriate treatment guidelines adherence. In the group of antipsychotics, second generation antipsychotics are broadly used; haloperidol consumption is high, clozapine is used rarely and depo forms are being widely prescribed. Anxiolytics, hypnotics and sedatives consumption is decreasing, which is a positive trend. Antidepressant consumption is different from trends seen in ambulatory settings and many different antidepressants are included.
CONCLUSION: The total medication costs were increasing in the observed period, especially in the N group of ATC classification, which could be explained by a payment change of depot antipsychotics. The total amount of consumed medicines within ATC classification groups, as well as the consumption on the level of active substances, did not significantly change neither in the number of issued packs per year nor in the number of DDDs per year between 2014 and 2018. This indicates a relatively stable medication use within the hospital (with some minor exceptions). We have recognised a need for a more thorough, systematic, comprehensive and permanent medication consumption research in Slovenia.
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