OBJECTIVESBiopharmaceuticals improved the prognosis and quality of life of patients with chronic diseases. The aim of our study was to analyse the total reported suspected adverse drug reactions ...(ADR) and ADRs of reference biologicals and their biosimilars in Slovakia. METHODSUsing data from the State Institute for Drug Control database, we analysed the trends of suspected ADR submitted between 2001-2017 including the registered biosimilars and their reference biologicals: erythropoietin, filgrastim and infliximab. RESULTSSevere suspected ADR represented 42.95 % from all the reported cases (n=13,462) over the time period 2006-2017 and 54.98 % over 2015-2017 respectively. Reports from 2015-2017 were further analysed. From 4,364 cases, 27 were associated with infliximab and one with erythropoietin. 75 % of these ADR were severe including one death. The difference between the suspected ADR for infliximab reference biological compared to the biosimilar was not statistically significant (p=0.171) after adjustment to the number of prescribed drug units. CONCLUSIONWe did not find any evidence of increased risks associated with biosimilars compared to reference biologics. The spontaneous reporting system represents an inexpensive tool of reporting ADRs and should be utilized more frequently by health professionals, but even more importantly, by patients (Tab. 3, Fig. 2, Ref. 30). Text in PDF www.elis.sk Keywords: adverse drug reaction, spontaneous reporting, biopharmaceuticals, biosimilars, infliximab.
The use of antiplatelet agents is strongly recommended for the secondary prevention of ischemic events such as myocardial infarction, stroke/transient ischemic attack (TIA).
The aim of our study was ...to analyse the use of antiplatelet medication in patients after myocardial infarction, stroke/TIA, and patients with both conditions and to identify patient-related characteristics, which determine the use of such drugs in elderly patients.
Study sample (n=372) was derived from 2,157 patients admitted to long-term care departments of three municipal hospitals. The study included patients aged ≥65 years after myocardial infarction, stroke/TIA or both.
Antiplatelet medications were prescribed in 54.8 % and 68.5 % of patients at hospital admission and discharge, respectively. Hospitalisation led to a significant increase in the use of antiplatelet medication in patients after myocardial infarction and in those with the combination of both events. However, in patients after only stroke/TIA, we did not find any significant difference comparing the use of antiplatelet medication at the time of hospital admission and discharge, respectively.
Our study revealed that physicians are more aware of the benefits of antiplatelet medication in elderly patients after myocardial infarction or those after both myocardial infarction and stroke/TIA in comparison with patients after only stroke/TIA (Tab. 3, Ref. 32).
The aim was to analyse the consumption of selected strong opioid analgesics during a seven-year period of 2003-2009 in order to compare Slovak consumption with that in six other European countries ...and to determine our position.
Drug consumption data from the State Institute for Drug Control in Slovak Republic were used. As to the data from other countries, annual health statistics published on websites were used in comparison.
Obviously the consumption of one of studied opioid drugs with transdermal aplication route, particularly fentanyl, tended to increase in all countries during the observed period. Oxycodone tends to yield a rapid increase in consumption as well. As opposed to the latter drugs, the consumption of morphine was decreasing throughout the observed period. The consumption of these drugs in Slovakia remains low (except for that of fentanyl).
Our analysis confirmed a clear shift from oral to transdermal therapy as well as usage of newer drugs. Drug consumption data are a relatively new source of information for health research. Our analysis showed increasing trends in fentanyl (patch opioid) consumption in all compared countries as well as an increasing consumption of oxycodone and decreasing consumption of morphine (Fig. 3, Ref. 17).
Summary
What is known and Objective: Analgesics are among the most widely used drugs and there is wide intercountry variability in the rates of consumption of different analgesics. Our objective is ...to determine and compare patterns of analgesic consumption in the Slovak Republic and a number of other European countries.
Methods: We undertook a drug utilization study using WHO ATC/defined daily doses (DDD) methodology. Wholesale analgesic data collected by the Slovak State Institute for Drug Control were used. Utilization was calculated as DDD per 1000 inhabitants per day. Comparison with wholesale data from Czech Republic, Estonia, Finland, Norway and Denmark, published on the Internet, was made.
Results and Discussion: Paracetamol/acetaminophen consumption varied only a little in Slovak Republic and Czech Republic, whereas consumption in Nordic countries was significantly higher (P < 0.05) and in Estonia significantly lower. Ibuprofen consumption was significantly higher in Czech Republic and Finland. Significantly lower consumption was in Norway. The lowest consumption of ASA/aspirin was in Denmark and in Norway. The highest consumption was in Finland.
What is new and Conclusion: Effective therapy needs good prescribing and well‐informed prescribers and patients. Our study highlights wide differences in analgesic consumption even among similar European countries. The basis of these differences and their potential clinical impact require further investigation.
Full text
Available for:
BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
The aim of our work was to analyze utilization patterns in Slovakia and Nordic countries and to determine coxib risk perception among medical professionals.
The consumption of coxibs in Slovakia ...during 1999-2009 was analyzed. Data were obtained from the State Institute for Drug Control in SR. Obtained results were compared to data based on annual health statistics in Denmark, Finland and Norway. General Practitioners were asked on a perceived risk.
We observed an increase of consumption in first years, followed with a marked decrease after year 2004. Slovak consumption was very small. Coxibs represented in Slovakia only a small part of totally prescribed non-steroidal anti-inflammatory drugs. They constituted only 1.44 % in the year 2003, whereas in Norway 41.2 %. 14 % of respondents (n=570) marked coxibs to be the safest analgesic drug.
Published data show that consumption of coxibs (rofecoxib was linked with serious thrombotic cardiovascular adverse effect) fall down markedly. Consumption data from 1999 until 2009 from Slovakia and three Nordic countries showed significant differences (p<0.001). During the observed period, the utilization of coxibs in Slovakia was very small - a possible explanation is new drug, higher prize, doctor's habits (Tab. 2, Fig. 1, Ref. 11).
To describe the patterns of consumption in an opioid analgesic group in Slovakia between 1998 and 2002, to determine prescription habits, and to compare the results with those from selected ...countries.
A drug utilization study using WHO methodology Anatomical-Therapeutic-Chemical classification/defined daily doses (ATC/DDD) was made. The wholesale data from the State Institute of Drug Control in the Slovak Republic and drug safety reports from the National Centre for Supervision of Adverse Drug Reaction were collected. Utilization was calculated as the DDDs per 1000 inhabitants per day.
Consumption of opioid analgesics (ATC class N02AA-N02AX) in Slovakia was still growing during the study with dominance of tramadol. In comparison with other countries in 2001, consumption of morphine (as a representative of analyzed ATC class) in Slovakia (0.17 DDD/1000 inhabitants per day) is still very low, in contrast with Denmark, Austria or Canada (1.80, 1.61 and 1.58 DDD/1000 inhabitants per day, respectively). The collected safety reports contained only a few reported adverse reactions to the opioid analgesics.
Despite recent increases, the consumption of opioid analgesics in the Slovak republic remains low. We have tried to present an overall picture of prescription of opioid analgesics in Slovakia and to focus attention on this topic.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Objective: Politicians are not the only ones who view medical care centers (MCC) as a model for the future. Even physicians often believe that they are better offwith such type of care. However, ...legal and tax expert Dr. Müller-Kern warns that this is not always true because profits do not increase for every partner and some even experience losses in revenue. This is because disciplines such as strategic planning, marketing, organization theory, quality management or project management run parallel to each other in classical business administration. This is how these disciplines are still taught in schools and universities today. Aim: Managing, controlling and (re-)designing businesses within the system of medical care has become an extremely challenging task. It is thus better to analyse beforehand whether it is really worthwhile. Results: In a comparison between the standard MCC/partnership and the practice clinic model, one can see that these are very different structures. Of interest are structures where both forms can be integrated within a single enterprise. Conclusion: Classic business management, which is based primarily on principles such as linearity, stability and deduction, is less and less capable of answering the burning questions of today's corporate governance. The structure of the German MCC is an excellent type for the medical field and has a very good prospect the next years.
Opioid analgesics are drugs of choice in the treatment of moderate and severe malignant or noncancer pain. Consumption data helps us to evaluate the status of country's public health.
We analysed the ...consumption of opioid analgesics from ATC class N02A in Slovakia in the year 2006 and compared it with five other countries -- Finland, Norway, Denmark, Spain and Australia. We then calculated drugs that accounted for 90% of the total volume of DDDs in the year 2006.
Slovakia showed a dominance of tramadol consumption that constituted three quarters of the total group consumption. Tramadol is the commonest consumed opioid analgesic in all observed countries (in Norway it constituted only 35% of total group consumption, whereas in Slovakia it was 72%).
Opioid consumption in Slovakia is increasing, but comparison with the Nordic countries, Spain and Australia showed a significantly lower consumption. Exception is tramadol with the highest consumption in Slovakia.
Observed trends in consumption indicate a well known accent of the Nordic countries on treatment of pain. Opiod consumption in Slovakia continues to stay low (Tab. 1, Fig. 1, Ref. 10). Full Text (Free, PDF) www.bmj.sk.
The aim of this study was to determine differences between PBL as compared to modified PBL with special focus on acquiring EBM principles.
Two groups consisted of total 152 students (139 ...respectively). The use of EBM principles means integrating individual expertise with the best available external clinical evidence by using available data sources and national guidelines.
Our findings suggest that modified PBL with extended EBM approach could be superior to "classical" PBL (Fig. 3, Ref. 29). Full Text (Free, PDF) www.bmj.sk.
PDF
