| Abstract [eng] |
Master's thesis of U. D. Dikmonas, scientific supervisor Prof. Dr. J. Gulbinovič: Consumption of Antipsychotic Drugs in Lithuania. Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences Pharmacy Center -Vilnius. Aim: to identify trends in the consumption of antipsychotic drugs in Lithuania from 2017 to 2022. Objectives: to assess the overall and individual consumption of antipsychotic drugs; to evaluate three antipsychotic drugs with the highest consumption based on patient demographic indicators; to identify differences in the consumption of antipsychotic medications by Lithuanian regions; to determine the prescribing of antipsychotic medications according to disease indications. Methodology: The study material includes data from Lithuanian open data portal on the ESPBI IS e-prescription subsystem regarding physician-prescribed prescription drugs for the years 2017, 2018, 2019, 2020, 2021, and 2022. To compare and assess changes in the consumption of antipsychotic drugs among each other, according to demographic indicators, and by regions, the Anatomical Therapeutic Chemical classification system/Defined Daily Doses (ATC/DDD) methodology is applied. For determining drug prescribing according to disease indications, the number of prescriptions per thousand inhabitants per respective sample years is calculated (prevalence indicator). Data is filtered and processed using "R Commander" within "R Studio", the calculations oof DDD per 1000 inhabitants per day and prescription prescribing by the ICD-10-AM disease indications are performed using "MS Office Excel." The obtained data is graphically represented, and a descriptive analysis of the results is conducted. Results and conclusions: From 2017 to 2021, there is an observed increase in e-prescription consumption (from 1,723 to 8,844 DDD/TID), followed by a decrease in 2022 to 7,560 DDD/TID. Drug consumption in 2017 and 2018 increases steadily each quarter, with the highest in quarters 2 and 3 from 2019 to 2022, slightly lower in quarter 4, and the lowest in quarter 1. The main groups are N05AH (clozapine, olanzapine, quetiapine) and N05AX (risperidone, aripiprazole, paliperidone, and cariprazine). According to DDD/TID, the highest consumption is olanzapine – 9,190, quetiapine – 8,763, haloperidol – 5,982, tiapride – 2,844, and paliperidone – 2,604. Most antipsychotics are consumed by females. The main age groups for consumption are 45-64 years old and over 65 years old. Men consume fewer antipsychotic drugs, with the main age groups being 45-64 years old and 18-44 years old. The lowest consumption is among individuals under 17 years old. According to e-prescription data over all the study years, Tauragė County had the highest total DDD/TID (56,486), Utena (43,444), Panevėžys County (42,054). The lowest e-prescription consumption was in Alytus County (27,692 DDD/TID). In Tauragė County, the top 5 most consumed drugs are quetiapine, olanzapine, haloperidol, tiapride, and paliperidone. In Utena County: olanzapine, quetiapine, haloperidol, tiapride, and aripiprazole. In Panevėžys County: quetiapine, olanzapine, haloperidol, paliperidone, tiapride. Analyzing trends in the prescription of antipsychotic drugs based on the number of issued e-prescriptions per 1,000 inhabitants, the highest total quantity is in: F20-F29 (181.33), F30-F39 (103.27), F00-09 (79.14), and F40-F48 (34.24). In the F20-F29 group, the main drugs over all the years are: olanzapine (39.42 prescriptions per 1,000 inhabitants), quetiapine (36.03 prescriptions per 1,000 inhabitants), haloperidol (30.02 prescriptions per 1,000 inhabitants), clozapine (18.52 prescriptions per 1,000 inhabitants), and risperidone (16.01 prescriptions per 1,000 inhabitants). |
