Drug Utilization Research : Methods and Applications

Drug Utilization Research (DUR) is an eclectic scientific discipline, integrating descriptive and analytical methods for the quantification, understanding and evaluation of the processes of prescribing, dispensing and consumption of medicines and for the testing of interventions to enhance the quality of these processes. The discipline is closely related and linked mainly to the broader field of pharmacoepidemiology, but also to health outcomes research, pharmacovigilance and health economics.

Drug Utilization Research is a unique, practical guide to the assessment and evaluation of prescribing practices and to interventions to improve the use of medicines in populations. Edited by an international expert team from the International Society for Pharmacoepidemiology (ISPE), DUR is the only title to cover both the methodology and applications of drug utilization research and covers areas such as health policy, specific populations, therapeutics and adherence.

Author Notes

Monique Elseviers , Centre for Research and Innovation in Care, University of Antwerp, Belgium.

Björn Wettermark , Associate Professor in Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden.

Morten Andersen , Visiting Professor, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden; Senior Physician at the Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden; Senior Researcher at the Research Unit for General Practice, University of Southern Denmark, Denmark.

Ria Benko , Associate Professor, Department of Clinical Pharmacy at the University of Szeged, Hungary.

Marion Bennie , Professor of Pharmacy Practice, University of Strathclyde, UK; Chief Pharmaceutical Adviser, NHS National Services Scotland, UK.

Brian Godman , Research Scientist, Karolinska Institutet, Stockholm, Sweden.

Janet Krska , Professor of Clinical and Professional Pharmacy, Medway School of Pharmacy, Universities of Greenwich and Kent, UK.

Elisabetta Poluzzi , Assistant Professor of Pharmacology, Department of Pharmacology, Faculty of Medicine, University of Bologna, Italy.

Katja Taxis , Associate Professor of Pharmacotherapy and Clinical Pharmacy, University of Groningen, Netherlands.

Vera Vlahovic-Palcevski , Professor, Department of Pharmacology, University of Rijeka Medical School, Croatia; Specialist in Clinical Pharmacology, University Hospital Rijeka, Croatia.

Robert Vander Stichele , practicing family physician in Ghent, Belgium.

Björn Wettermark and Monique Elseviers and Anna Birna Almarsdóttir and Morten Andersen and Ria Benko and Marion Bennie and Irene Eriksson and Brian Godman and Janet Krska and Elisabetta Poluzzi and Katja Taxis and Robert Vander Stichele and Vera Vlahovié-PalcevskiBjörn Wettermark and Mirko Di Martina and Monique ElseviersTatiana Chama Borges Luz and Evalill NilssonIrene Eriksson and Luisa IbáñezMarit Rønning and Stuart McTaggartHege Salvesen BlixJesper Hallas and Henrik Støvring and Anton PottegårdSabine Vogler and Jaana E. MartikainenDouglas T. Steinke and Monique ElseviersMaria Matuz and Ria Benko and Mikael HoffmannJuan MerloStephen Campbell and Björn Wettermark and Morten AndersenAnna Birna Almarsdóttir and Pia Bastholm RahmnerVera Vlahovic-Palcevski and Björn Wettermark and Luisa Ibáñez and Robert Vander SticheleSean MacBride-Stewart and Ksenia Zagorodnikova and Irene Langner and Gisbert W. SelkeEric Van Ganse and Laurent Laforest and Nieis AdriaenssensIrene Eriksson and Ulf Bergman and Vera Vlahovic-Palcevski and Mia von EulerTatiana Chama Borges Luz and Claudia Garcia Serpa Osorio-de-Castro and Björn WettermarkBrian Godman and Hye Young Kwon and Marion Bennie and Anna Birna AlmarsdóttirBrian Godman and Roberta Joppi and Marion Bennie and Saira Jan and Björn WettermarkBrian Godman and Marion Bennie and Claudia Garda Serpa Osorb-de-Castro and Vu Thi Thu Huong and Saira JanRichard Torbett and Donald Han and Indranil BagchiHedvig NordengAntje Neubert and Katja Taxis and Ian C.K. WongKatja Taxis and David O'Sullivan and Shane Cullinan and Stephen ByrneRia Benko and Marion Bennie and Samuel CoenenElisabetta Poluzzi and Maarit Jaana KorhouenHelga Zoëga and Alesha Smith and Nadia BarozziCarlo Piccinni and Luigi Naldi and Martin NeoviusNils Wilking and Thomas Hofmarcher and Ulla Wilking and Bengt JöussonPaul Spivey and Brian GodmanColin Bradley and Kathleen Holloway and Janet KrskaJanine Traulsen and Nicky Britten and Janet KrskaBernard VrijensMonique Elseviers and Bernard VrijensJean-Pierre Grégoire and Jocelyne MoisanMarie-Paule Schneider and Jennifer Celio and Yoleen van Camp and Matthias CavassiniGiampiero Mazzaglia and Peter MolEmanuel Raschi and Fabrizio De PontiXavicr Kurz and Kevin BlakeHenrik Toft Sørensen and Gianluca TrifiròCara Usher and Kathleen Bennett and Lorenzo G. Mantovani and Dyfrig HughesPetra Denig and Flora Haaijer-Ruskamp and Lisa PontHanne HerborgJens Søndergaard and Dorte Gilså Hansen and Debra RowettElizabeth Roughead and Andrew GilbertFrank MayHubert G.M. Leufkens and Frank May and Nicky Britten

List of contributors	p. viii
Acknowledgements	p. xiv
About the companion website	p. xix
Part 1 Introduction
1 Introduction to drug utilization research	p. 3
Part 2 Methodology
2 Study designs in drug utilization research	p. 15
3 Primary data collection for drug utilization research	p. 29
4 Secondary data sources for drug utilization research	p. 39
5 Classification systems for drugs and diseases	p. 49
6 Measurement units of drug utilization	p. 58
7 Individual-level drug utilization analyses	p. 68
8 Measurement of drug expenditure	p. 77
9 Basic statistical methods in drug utilization research	p. 88
10 Visualization of drug utilization data	p. 99
11 Multilevel analyses in drug utilization research	p. 116
12 Defining and developing quality indicators for drug utilization	p. 126
13 Qualitative methods in drug utilization research	p. 139
Part 3 Applied drug utilization research
Section A Comparative drug utilization research
14 Comparison of drug utilization across different geographical areas	p. 153
15 Comparison of drug utilization in different health care settings	p. 160
16 Time-dependent and seasonal variations in drug utilization	p. 173
17 Comparative studies of patient and prescriber characteristics	p. 184
18 Comparative studies of health systems	p. 194
Section B Drug utilization and health policy
19 Drug utilization and health policy	p. 203
20 Managed introduction of new drugs	p. 210
21 Management of drugs in the health care system	p. 222
22 The pharmaceutical industry and health policy	p. 231
Section C Drug utilization in specific populations
23 Drug utilization in pregnant women	p. 240
24 Drug utilization in the paediatric population	p. 248
25 Drug utilization in older people	p. 259
Section D Drug utilization in specific therapeutic areas
26 Drug utilization research in the area of antibiotics	p. 270
27 Drug utilization research in the area of cardiovascular medicines	p. 284
28 Drug utilization research in the area of analgesics and psychotropics	p. 294
29 Drug utilization research in the area of biologicals	p. 302
30 Drug utilization research in the area of cancer drugs	p. 315
Section E Determinants of drug utilization
31 Health system perspectives	p. 328
32 Prescriber perspectives	p. 336
33 Patient perspectives	p. 347
Section F Adherence and drug utilization research
34 An introduction to adherence research	p. 355
35 Assessment of medication adherence in field research	p. 361
36 Assessment of adherence to drug treatment in databas`e research	p. 369
37 Interventions to improve adherence to drug treatment	p. 381
Section G The role of drug utilization within the field of pharmacoepidemiology
38 Drug utilization research and risk management	p. 392
39 Drug utilization research and pharmacovigilance	p. 399
40 Drug utilization research and the regulator's perspective in pharmacovigilance	p. 408
41 Drug utilization research and outcomes research	p. 417
42 Drug utilization research and pharmacoeconomics	p. 425
Section H Assessment and improvement of the quality of medicine use
43 Assessment of quality of prescribing using quality indicators	p. 433
44 Quality indicators for patient care in pharmacy practice	p. 443
45 Interventions that influence prescribing decisions and drug utilization	p. 460
46 Development, delivery and evaluation of implementation programmes	p. 468
47 Towards a better understanding of prescribing-enhancement interventions	p. 477
Part 4 Epilogue
48 The many futures of drug utilization research	p. 489
Glossary	p. 492
Index	p. 497

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