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Læknablaðið - 15.01.1994, Síða 20

Læknablaðið - 15.01.1994, Síða 20
10 LÆKNABLAÐIÐ spurning hvort sjúklingar, sem nota lyfin við lífsstflstengdum vandamálum, eigi ekki að greiða stærri hlut í kostnaði lyfjanna en hinir sem taka þau við vel skilgreindum sjúkdómum. ÞAKKIR Höfundar vilja þakka lyfsölum og lyfjafræðingum í apótekum fyrir mjög góða samvinnu við að afla upplýsinga sem þessi grein byggist á. SUMMARY Drugs for peptic ulcer (ACT class A02B) are extensively used in Iceland, 20 DDD/1000/day, which is 2-3 times higher than in other Scandinavian countries. A prescription survey was carried out during one month in 1991 with the help of pharmacists who registered all prescriptions with regard to age and sex of the patient, the speciality of the prescribing doctor and name, dose and quantity of the drug. A total of 2021 prescriptions were registered accounting for around 90% of all prescriptions. The prevalence of peptic ulcer drug use was 1.52% and maximal usage was in the age group 70-79, 2.91%. H, blockers accounted for 79%, omeprazole for 17%, and other drugs for 4%. General practitioners prescribe 65% of the drugs, gastroenterologists 15% and other specialists 14%. If the patient himself collected the drug he was asked to fill out a questionnaire with regard to the reason for the prescription, previous prescriptions and investigations. A total of 1131 (56%) questionnaires were received. Only 1% of the patients did not know the reason for the prescription. The patients registered that 30% of the prescriptions were for peptic ulcer, 29% for heartburn, 21% for gastritis, 9% for dyspepsia and 7% for prevention of side effects of other drugs. Investigations were done in 67% of the patients, but 33% received prescription after doctor’s interview only. It was estimated from the data that about 40% of the prescriptions were for non-ulcer dyspepsia. The results suggest that the extensive use of peptic ulcer drugs in Iceland is due to excessive use in non-ulcer dyspepsia. HEIMILDIR 1. Wyllie JH, Clark CG, Alexander Williams J, et al. Effect of cimetidine on surgery for duodenal ulcer. Lancet 1981; i: 1307-8. 2. Baron JH, Alexander Williams J, Beasnell JR. Cimetidine and duodenal ulcer. Br Med J 1979; 1: 169-73. 3. Bardham KD, Hinchliffe RFC. Effect of cimetidine on surgery for duodenal ulcer. Lancet 1981; ii: 38. 4. Penn I. The deciining role of the surgeon in the treatment of acid peptic diseases. Arch Surg 1980; 115: 134-5. 5. Fineberg HV, Pearlmann LA. Surgical treatment of peptic ulcer in the United States. Trends before and after the introduction of cimetidine. Lancet 1981; i: 1305-7. 6. Tilvis RS, Vuoristo M, Varis K. Changed profile of peptic ulcer disease in hospital patients during 1969- 1984 in Finland. Scand J Gastroenterology 1987; 22: 1238-44. 7. Bardham KD, Cust G, Hinchliffe RCF, Williamson FM, Lyon C, Bose K. Changing pattem of admissions and operations for duodenal ulcer. Br J Surg 1989; 76: 230-6. 8. Kurala JH, Honda GD, Frantel H. Hospitalization and mortality rates for peptic ulcer: a comparison of a large health maintenance organization and United States data. Gastroenterology 1982; 83: 1008- 16. 9. Makela J, Lattinen J. Kauruloma MI. Complications of peptic ulcer disease before and after the introduction of H2 receptor antagonists. Hepato- Gastroenterology 1992; 39: 144-8. 10. Christensen A, Bousfield R. Ulcuskirurgi för och efter indförelsen af H, blokker behandlinger. Ugeskr Læger 1987; 149/43: 2895-7. 11. Walt R, Katschinski B, Logan R, Ashley J, Langmann M. Rising frequency of ulcer perforation in elderly people in the United Kingdom. Lancet 1986; i: 489- 92. 12. Hansen JM, Bytzer F, Muckadell OB. Ulcuskomplikationer i Fyns Amt i perioden 1980- 1990. Ugeskr Læger 1991; 153: 1402-5. 13. Koo J, Ngan YK, Lam SK. Trends in hospital admission, perforation and mortality of peptic ulcer in Hong Kong from 1970-1980. Gastroenterology 1983; 84: 1558-62. 14. Penston JG, Wormsley KG. Nine years of maintenance treatment with ranitidine for patients with duodenal ulcer disease. Aliment Pharmacol Ther 1992; 6: 629-45. 15. Penston JG, Wormsley KG. Trends in morbitidy and mortality from peptic ulcer disease. Tayside versus Scotland. Aliment Pharmacology and Therapeutics 1993; 7: 429-42. 16. La Vecchia C, Lucchini F, Negri E, Reggi V, Levi F. The impact of therapeutic improvements in reducing peptic ulcer mortality in Europe. Int J Epidemiol 1993; 22: 96-106. 17. Nordic Statistics on Medicines 1987-1989. NLN Publication 1990; 30: 47. 18. Icelandic drug market. 2Q 1991. Kpbenhavn: Dansk lægemiddelstatistik, 1991. 19. Thors H, Sigurðsson H, Oddsson E, Þjóðleifsson B. Aðgerðir við ulcus pepticum á Islandi 1971-1989. Læknablaðið 1992 / Fylgirit 21: 62. (Ágrip). 20. Thors H. Sigurðsson H. Oddsson E, Þjóðleifsson B. Dánartíðni af völdum ulcus pepticum á íslandi 1950- 1990. Læknablaðið 1992 / Fylgirit 21: 63. (Ágrip). 21. Dungal N, Hansen H, Schweiz Z. Peptic ulcers in Iceland. Path Bakt 1958; 21: 225-8. 22. Bonnevie O. Changing demographics of peptic ulcer disease. Dis Dis Sci 1985; 30 / Suppl. 11: 85-145. 23. Colin Jones DG, Bloom B, Bodemar G. The management of dyspepsia: Report of a Working Party. Lancet 1988; i: 576-9. 24. Gudjónsson H, Oddsson E, Bjömsson S, et al.

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