| Summary: | 碩士 === 國立成功大學 === 臨床藥學研究所 === 98 === Background
Systemic corticosteroids (CSs) are used to treat patients with endocrine, inflammatory, allergic, or immunological disorders, which may cause in many adverse effects in chronic use. There are lots of studies about the prescription patterns of CSs and the association between CSs use and adverse effects in western countries. However, information describing the population-based use of corticosteroids in Taiwan remains unavailable. Therefore, this study was aimed to investigate utilization of systemic CSs in Taiwan.
Methods
We included systemic CSs users who were documented prescriptions of H02 in ATC code from the non-sampled National Health Insurance Research Database (NHIRD).
There were two groups to classified for the analysis:
1) who had received one or more prescriptions of systemic CSs during 1 January 2004 and 31 December 2004 .
2) who had continued treatment more than 3 months (92 days) during 1 January 2001 and 31 December 2003
Results
In the cross-sectional study, we enrolled 4,416,874 CSs users, and the prevalence was 195 per 1000 persons. Nearly 72% of CSs users received only 1 or 2 prescriptions in 2004. Prednisolone was the most frequently prescribed CSs, and the consumption was 4.8 DDD/inhabitant/day. The highest consumption of CSs was found with people between 90 and 95 years of age (11 DDD) in impatient service and 75 and 85 years of age (12.5 DDD) in ambulatory patients. The most frequently recorded diagnosis associated with CSs use was neoplasm, and respiratory disease in impatient service and ambulatory care, respectively.
In the part of long-term users, we enrolled 123,159 CSs long-term users, and the annual prevalence was 2.9 per 1000 people in 2003. The prevalence of long-term users ＜20, 20 to 64, and ＞64 years of age was 0.5, 2.4 and 12.6, respectively. The most frequently prescribed dose was between 5 and 7.5 mg/day. The most common diagnosis associated CSs use was respiratory disease (32%), followed by rheumatic disease (23%). Nearly 24% of long-term users had no documented diagnosis indicating the appropriateness of CSs use.
Conclusions
A large number of patients enrolled in NHIRD had received one or more CSs in 2004 which was more prevalent than other countries. Most of them were short-term users, and the most frequently diagnosis associated CSs use was upper respiratory tract infection. The utilization pattern awakes future investigate.
The prevalence of long-term users was similar with other country. While age was increasing, the prevalence raised as well as the percentage of daily dose. The risk and benefit of systemic CSs in the elderly should be concerned.
Keywords
Prescribing pattern, Corticosteroids, Glucocorticoids, Steroids
|
|---|
