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Drug utilisation in outpatient children. A comparison among Tenerife, Valencia, and Barcelona (Spain), Toulouse (France), Sofia (Bulgaria), Bratislava (Slovakia) and Smolensk (Russia)

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Introduction

Scarce information about comparative diagnostic and therapeutic patterns in paediatric outpatients of different countries is found in the literature.

Objective

To describe the similarities and differences observed in diagnosis and therapeutic patterns of paediatric patients of seven locations in different countries.

Design

Cross-sectional, prospective, international comparative, descriptive study.

Patients and methods

A randomly selected sample of 12,264 paediatric outpatients seen in consultation rooms of urban and rural areas and attended by paediatricians or general practitioners of the participating locations. Data on patient demographic information, diagnosis and pharmacological treatment were collected using pre-designed forms. Diagnoses were coded using the ICD-9 and drugs according to the ATC classification.

Results

Among the ten most common diagnoses, upper respiratory tract infections are in the first position in all locations; asthma prevalence is highest in Tenerife (8.4%). Tonsillitis, otitis, bronchitis and dermatological affections are the most common diagnoses in all locations. Pneumonia is only reported in Sofia (3.8%) and Smolensk (2.3%). The average number of drugs prescribed per child varied from 1.3 in Barcelona to 2.9 in Smolensk. There are no great differences in the profile of pharmacological groups prescribed, but a considerable range of variations in antibiotic therapy is observed: prescription of cephalosporins is low in Smolensk (0.7%) and higher in the other locations, from 16.5% (Bratislava) to 28% (Tenerife). Macrolides prescriptions range from 12.6% (Toulouse) to 24.7% (Smolensk), except in Sofia where they drop to 5.6%. Trimethoprim and its combinations are used in Smolensk (23.3%), Sofia (11.8%) and Bratislava (8.7%). Check-up consultations are not recorded in Smolensk and Bratislava, whereas in Toulouse these visits account for 16.2% of all consultations and in the other locations the percentage varies from 6.1% (Tenerife) to 1.9% (Sofia). Homeopathic treatments are registered only in Toulouse.

Conclusion

Except in asthma prevalence, there are no great differences in diagnostic maps among locations. Significant variations in the number of drugs prescribed per child and antibiotic therapies are observed. Areas for improvement have been identified.

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Authors and Affiliations

  1. Department of Clinical Pharmacology, School of Medicine, University of La Laguna, 38071 , La Laguna, Tenerife, Spain

    E. Sanz & M. A. Hernández

  2. State Medical Academy, Department of Clinical Pharmacology, Smolensk, Russia

    S. Ratchina & L. Stratchounsky

  3. CAP San Gervasio, Instituto Catalán de la Salud (ICS), Barcelona, Spain

    M. A. Peiré

  4. Department of Clinical Pharmacology, School of Medicine, Toulouse University, France

    M. Lapeyre-Mestre & B. Horen

  5. Department of Clinical Pharmacology, Comenius University, Bratislava, Slovakia

    M. Kriska & H. Krajnakova

  6. National Drug Agency, Ministry of Health, Sofia, Bulgaria

    H. Momcheva & D. Encheva

  7. Hospital Management, Valencia University General Hospital Consortium and HGU Foundation, Spain

    I. Martínez-Mir

  8. Service of Internal Medicine, Hospital de la Ribera, Alzira, Valencia, Spain

    V. Palop

Authors
  1. E. Sanz
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  2. M. A. Hernández
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  8. M. Kriska
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  9. H. Krajnakova
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  13. V. Palop
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Correspondence to E. Sanz.

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Sanz, E., Hernández, M.A., Ratchina, S. et al. Drug utilisation in outpatient children. A comparison among Tenerife, Valencia, and Barcelona (Spain), Toulouse (France), Sofia (Bulgaria), Bratislava (Slovakia) and Smolensk (Russia). Eur J Clin Pharmacol 60, 127–134 (2004). https://doi.org/10.1007/s00228-004-0739-y

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  • DOI: https://doi.org/10.1007/s00228-004-0739-y

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