Drug utilization research methods and applications 1st Edition by Monique Elseviers and 12 more ISBN 1118949781 978-1118949788

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ISBN 10: 1118949781
ISBN 13: 978-1118949788
Author: Monique Elseviers and 12 more

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.

Drug utilization research: methods and applications 1st Table of contents:

Part 1: Introduction

Chapter 1: Introduction to drug utilization research

Room for improvement in drug utilization

The history of drug utilization research

Definition and delineation

Skills needed to be a drug utilization researcher

Areas of inquiry in drug utilization research reflected in this book

Part 2: Methodology

Chapter 2: Study designs in drug utilization research

Introduction

Quantitative and qualitative research

Observational studies: from descriptive to analytical approaches

Study designs for descriptive drug utilization studies

Study designs for analytical drug utilization studies

Experimental and quasiexperimental study designs in drug utilization research

Other study designs for drug utilization research

Chapter 3: Primary data collection for drug utilization research

Introduction

Identifying primary data sources for drug utilization research

Collecting valuable primary data in drug utilization research

Instruments and forms for primary data collection in drug utilization research

Modes of primary data collection for drug utilization research

Ethical considerations

Conclusion

Chapter 4: Secondary data sources for drug utilization research

Introduction

Sales data

Electronic health records

Pharmacy dispensing data

Reimbursement data

Patient registries

Secondary analysis of population health survey data

Record linkage in drug utilization research

Privacy, confidentiality and security

Data quality

Chapter 5: Classification systems for drugs and diseases

Introduction

ATC

Other drug classification systems

Other classification systems relevant for drug utilization research

Linkage of classification systems

Chapter 6: Measurement units of drug utilization

Introduction

DDD: definition and general considerations

Principles of DDD assignment

Alterations and misuse of DDDs

Other aggregate measures for prescribing

Other drug utilization metrics

Use of drugs in animals

How to report aggregated drug use

DDDs for special population groups

Chapter 7: Individual-level drug utilization analyses

Introduction

General principles

Epidemiological measures

Other measures

Strengths and limitations of individual-level statistics

Chapter 8: Measurement of drug expenditure

Introduction

Definitions and perspectives

Price-related units of pharmaceutical expenditure

Methodological challenges related to pharmaceutical expenditure

Chapter 9: Basic statistical methods in drug utilization research

Introduction

Why we need statistical methods in drug utilization and health services research

Use of population data versus sample data

Types of variables

Describing data with descriptive statistics

Investigating the difference between the means and medians of numerical variables

Investigating the difference between proportions of categorical variables

Understanding the notion of a risk calculation

Describing the relationship between two numerical variables using regression analysis

Assessing the combined effect of explanatory variables in multivariate statistical analysis

Summarizing the results of different studies in a meta-analysis

Conclusion

Chapter 10: Visualization of drug utilization data

Introduction

Basic (static) graphical display of findings

Interactive visualization – including time and geospatial visualization

Practical hints and tools

Conclusion

Chapter 11: Multilevel analyses in drug utilization research

Introduction

Multilevel structures

Why are MLRA techniques necessary?

Basic concepts in MLRA: a didactic example

A real empirical example

Conclusion

Acknowledgements

Notes

Chapter 12: Defining and developing quality indicators for drug utilization

Introduction

Definition of a quality indicator

Dimensions and classifications

Data sources

Drug-oriented prescribing quality indicators

Disease-oriented prescribing quality indicators

Other types of indicator

Development and validation of prescribing quality indicators

Conclusion

Chapter 13: Qualitative methods in drug utilization research

Reasons for using qualitative methods in drug utilization research

The role of qualitative research methods in drug utilization research

Research questions within drug utilization research that require qualitative research methods

Common qualitative data collection methods that could benefit drug utilization research

Sampling strategies in qualitative research

Analysis of data gathered in qualitative research

Validity concepts in qualitative research

Conclusion

Part 3: Applied drug utilization research

Section A: Comparative drug utilization research

Chapter 14: Comparison of drug utilization across different geographical areas

Introduction to comparative studies

Practical guide to geographical comparisons of drug utilization

Regional drug utilization comparisons

Cross-national drug utilization comparisons

Data collection for CNCs

Methodological challenges in CNCs

National activities that can facilitate CNCs

Conclusion

Chapter 15: Comparison of drug utilization in different health care settings

Health care settings

The relevance of drug utilization research in the hospital and ambulatory care settings

Comparative drug utilization studies provide transparency and input for other areas of research

Conclusion

Chapter 16: Time-dependent and seasonal variations in drug utilization

Introduction

Life cycle of a drug

Examples of factors influencing the natural life cycles of drugs

Utility of variation in drug utilization over time in the surveillance of health care issues

Examples of seasonal drug use variability

Conclusion

Chapter 17: Comparative studies of patient and prescriber characteristics

Introduction

Patient characteristics and drug use

Prescriber characteristics and drug use

Concordance of patient and prescriber characteristics

Conclusion

Chapter 18: Comparative studies of health systems

Introduction

The role of medicines in health care systems

Drug utilization studies and health care systems

Comparative drug utilization studies of health care systems

Drug utilization studies of self-medication and nonprescription drugs

Conclusion

Section B: Drug utilization and health policy

Chapter 19: Drug utilization and health policy

Introduction

Defining pharmaceutical policy

Forming pharmaceutical policy across the globe

Legal and institutional framework

Influencing pharmaceutical expenditure

Conclusion

Chapter 20: Managed introduction of new drugs

Introduction

New models to improve the rational use of new medicines

Conclusion

Chapter 21: Management of drugs in a health care system

Introduction

Supply-side measures

Demand-side measures

Policy case histories

Conclusion

Chapter 22: The pharmaceutical industry and health policy

Introduction

Ensuring value for money when financing future health needs

Application of drug utilization methods throughout the product life cycle

Conclusion

Section C: Drug utilization in specific populations

Chapter 23: Drug utilization in pregnant women

Background

Sources used in drug utilization studies in pregnancy

Methodological considerations in drug utilization studies in pregnancy

Conclusion

Chapter 24: Drug utilization in the paediatric population

Introduction

The need for paediatric drug utilization studies

Age categories and sample size issues

Data sources

Measurement units

Off-label use

Examples of paediatric drug utilization studies

Conclusion

Chapter 25: Drug utilization in older people

Introduction

Prescribing patterns in older people

Assessing prescribing quality

Deprescribing

Conclusion

Section D: Drug utilization in specific therapeutic areas

Chapter 26: Drug utilization research in the area of antibiotics

Introduction

Antibiotic use in relation to antibiotic resistance

Antibiotic use in ambulatory care

Antibiotic use in hospital care

Conclusion

Chapter 27: Drug utilization research in the area of cardiovascular medicines

Introduction

Trends in utilization of cardiovascular drugs

Antihypertensive drugs

Lipid-lowering therapy

Antithrombotic drug therapy: oral anticoagulants

Antithrombotic drug therapy: acetylsalicylic acid

Patient adherence to cardiovascular drugs

Cardiovascular polypharmacy

Conclusion

Chapter 28: Drug utilization research in the area of analgesics and psychotropics

Introduction

Pain medications

Psycholeptics: antipsychotics, anxiolytics and hypnotics/sedatives

Psychoanaleptics: antidepressants and psychostimulants

Conclusion

Chapter 29: Drug utilization research in the area of biologicals

Introduction

Multiple sclerosis

Rheumatoid arthritis

Psoriasis

Potentials and pitfalls of using registries in drug utilization research

Conclusion

Chapter 30: Drug utilization research in the area of cancer drugs

Background

Drug utilization studies in oncology

Methodological aspects

Conclusion

Section E: Determinants of drug utilization

Chapter 31: Health system perspectives

Introduction

Access to medicines

Finance and affordability

Supply and availability

International influences

Conclusion

Chapter 32: Prescriber perspectives

Introduction

Education of prescribers

Making prescribing decisions

Prescribing processes

Influences on prescribers

Additional issues in low-income countries

Conclusion

Chapter 33: Patient perspectives

Introduction

Importance of the patient perspective

Key issues in medicine use

Actual use of medicines

Use of information about medicines

Determining the patient perspective on medicines

Involving patients in drug development and monitoring

Conclusion

Section F: Adherence and drug utilization research

Chapter 34: An introduction to adherence research

Definition and taxonomy

The importance of patient adherence to medications

Measurement of adherence

Considerations for future research

Chapter 35: Assessment of medication adherence in field research

Introduction

Assessment of adherence

Reporting adherence estimates

Measuring adherence using electronic monitoring

Measuring adherence using questionnaires

Other as measures of adherence in field research

Advantages and disadvantages of different adherence assessment tools

Conclusion

Chapter 36: Assessment of adherence to drug treatment in database research

Introduction

Measuring adherence: prescription versus dispensing administrative data

Measurement selection

Measuring initiation

Measuring persistence/discontinuation

Measuring compliance (implementation)

Limitations of administrative data

Conclusion

Chapter 37: Interventions to improve adherence to drug treatment

Introduction

Determinants of medication adherence

Research on medication adherence-enhancing interventions

Transfer of intervention programmes in routine care

Interdisciplinary approaches

Conclusion

Section G: The role of drug utilization within the field of pharmacoepidemiology

Chapter 38: Drug utilization research and risk management

Introduction

Drug utilization research and risk assessment

Drug utilization research and risk minimization

Conclusion

Disclaimer

Chapter 39: Drug utilization research and pharmacovigilance

The new era of pharmacovigilance in Europe

Getting the most out of current SRSs

Combining drug utilization data with spontaneous reports

Conclusion

Acknowledgements

Chapter 40: Drug utilization research and the regulator’s perspective in pharmacovigilance

Introduction

Specific objectives of drug utilization studies in pharmacovigilance

Experience of drug utilization studies in the EU PAS Register

Measurement of the effectiveness of risk minimization

Measurement of the public health impact of adverse drug reactions

Conclusion

Disclaimer

Chapter 41: Drug utilization research and outcomes research

Introduction

Multiple roles of drug utilization in outcome research

Advantages and limitations of different sources of drug utilization data in outcomes research studies

Conclusion

Acknowledgment

Chapter 42: Drug utilization research and pharmacoeconomics

Introduction

Challenges in health care decision-making

Frameworks of economic evaluation

Choice of comparator drug

Identifying the incidence/prevalence of disease (morbidity data)

Describing current treatment pathways or disease management patterns and contributing to cost-of-illness studies

Comparative effectiveness and safety

Medication adherence

Costs of drugs

Budget impact analysis

Performance-based risk sharing

Developing local formulary/clinical practice guidelines

Communicating to prescribers

Assessing the impact of health policy initiatives

Section H: Assessment and improvement of the quality of medicine use

Chapter 43: Assessment of quality of prescribing using quality indicators

Introduction

Conceptual framework

Diabetes and cardiovascular risk management

Medication safety in the elderly

Prescribing quality indicators in practice

Conclusion

Chapter 44: Quality indicators for patient care in pharmacy practice

Introduction

Dimensions of quality in pharmacy practice

Pharmacy interventions and intervention studies

Review of existing and validated quality indicators

Application of quality indicators in pharmacy practice

Chapter 45: Interventions that influence prescribing decisions and drug utilization

Introduction

Classification of interventions

Educational/professional interventions

Developing an intervention strategy

Conclusion

Chapter 46: Development, delivery and evaluation of implementation programmes

Introduction

Theoretical models of behavioural and organizational change

Theoretical models supporting successful implementation programmes

Application of these theoretical models to the three stages of implementation programmes: development, implementation and evaluation

Conclusion

Chapter 47: Towards a better understanding of prescribing-enhancement interventions

Introduction

The indeterminate nature of pharmacotherapeutics

Classification of interventions which influence prescribing

Definitions, boundary delineations and outcome and context problems

Complex interventions

Evolution of methods of evaluating complex interventions

Conclusion

Part 4: Epilogue

Chapter 48: The many futures of drug utilization research

Introduction

Drivers of the future

Promises for the future

Caveats for the future

The role of patients

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