Evolución del consumo de macrólidos y amoxicilina/clavulánico en varios países europeos (2007-2010)
Objectives Describe the consumption data of macrolides and amoxicillin/clavulanic, supplied by International Marketing Services (IMS), a commercial drug data provider during 2007-2010 in the outpatient - inpatient healthcare sector in 10 European countries. Determine if changes in consumption patter...
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| Tipo de recurso: | tesis doctoral |
| Fecha de publicación: | 2015 |
| País: | España |
| Institución: | Universitat Autònoma de Barcelona |
| Repositorio: | Dipòsit Digital de Documents de la UAB |
| Idioma: | español |
| OAI Identifier: | oai:ddd.uab.cat:149372 |
| Acceso en línea: | https://ddd.uab.cat/record/149372 |
| Access Level: | acceso abierto |
| Palabra clave: | Antibiòtics Antibiòtics macròlids Amoxicil·lina |
| Sumario: | Objectives Describe the consumption data of macrolides and amoxicillin/clavulanic, supplied by International Marketing Services (IMS), a commercial drug data provider during 2007-2010 in the outpatient - inpatient healthcare sector in 10 European countries. Determine if changes in consumption patterns could be correlated with some demographic, economic and socio-cultural variables. Methods We investigated macrolides and amoxicillin/clavulanic acid out- and inpatient consumption, for 10 European countries (Germany, Denmark, Spain, France, Italy, Norway, Poland United Kingdom and Sweden). Data were provided by IMS Health extracted from Multinational Integrated Data Analysis System (MIDAS) database. The volume of consumption is expressed in 31D/1000 inhabitants/day (DID). All analyses were conducted in Excel 2007®. The "Data Analysis and Statistical Software" (STATA) statistical package was used to correlate consumption data with demographic variables: distribution of population by age and sex, economics: gross domestic product (GDP), purchasing power parity (PPP) per capita, total health expenditure as percentage of national GDP, cultural dimensions: Hofstede's scores (power distance, individualism, masculinity, uncertainty avoidance, long-term orientation and indulgence) for the different countries studied. Results For macrolides, total consumption ranged in 2010 from 0.33 DID in Sweden up to 5.14 DID in Italy. For amoxicillin/clavulanic acid, the consumption ranged in 2010 from 0.30 DID in Sweden up to 11.95 DHD in Spain. Over the 4 years of study, the consumption of macrolides slightly decreased in the majority of countries, except Germany, Italy and United Kingdom. For amoxicillin/clavulanic acid, an opposite trend was observed in 9 out of 10 countries. There was an increased amoxicillin/clavulanic acid consumption, except in Spain that showed a slightly decrease, and in Sweden that remained stable for 2007 and 2010. Regarding the correlations, demographic variables, consumption of two groups of antibiotics studied was found positively correlated with the proportion of women expressed as gender ratio. Likewise, the consumption of antibiotics in both groups correlated negatively with the economic variable PPP per capita. As for Hofstede's cultural dimensions, regarding the consumption of amoxicillin/clavulanic acid, statistically significant positive correlation with power distance and uncertainty avoidance was observed, negative correlation with indulgence was found. In terms of consumption of macrolides this was correlated positively with the cultural dimension of masculinity and negatively with indulgence. Conclusions The application of the ATC / 31D methodology in the context of the use of inpatient and outpatient drugs allows for comparisons of the two health settings and among different countries. The main consumption of J01CR02 and J01FA is in the outpatient setting. IMS Health data provide useful information on the consumption of drugs and nationwide sales of the studied antibiotics. The results from the present study show that there is a high variability in the consumption of macrolides and amoxicillin/clavulanic acid among the analyzed countries in the outpatient and inpatient setting. This significant heterogeneity suggests important differences in prescription habits. Our findings of correlations suggest that the study of different determinants of antibiotic prescription in various European countries may to some extent be controlled or influenced as health measures with a collective perspective. More research to better understand the complex effect of cultural dimensions in the context of the use of antibiotics is justified |
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