Abstract
Objective: To illustrate the best approach to accurate representation of temporal evolution of drug consumption, when confronted with changes over time in the Defined Daily Dose (DDD) measurement unit. Method: As an example, drug consumption (2001–2005) at the University Hospital Rijeka was expressed with the corresponding DDD in each year; and with the DDD value of the last year of the observation time window. By visual appraisal, results with both methods were compared with the graph of drug consumption trends expressed in physical units (mg, IU, etc.). Results: Of 20 drugs for which the DDD value has changed in the 5 year period, 5 were used in Rijeka hospital: erythropoietin parenteral, budesonide nasal spray, repaglinide oral, amoxicillin with clavulanic acid parenteral, and fentanyl transdermal. Graphs for individual drugs with the year by year method showed artificial jerks in the years proceeding the year of DDD change. Representation of total hospital consumption did not differ notably with the two methods. Conclusion: Drug consumption data should be calculated with the latest DDD value in the time window. The policy of the World Health Organisation to keep changes to the system of DDD to a minimum should be continued.
References
WHO Collaborating Centre for Drug Statistics Methodology.http://www.whocc.no/atcddd/. Last accessed 30 Oct 2009.
Rønning M. Coding and classification in drug statistics—from national to global application. Nor J Epidemiol. 2001;1(1):37–40.
Wettermark B, Vlahovic-Palcevski V, Salvesen Blix H, Ronning M, Vander Stichele RH. Drug utilization research. In: Hartzema AG, Tilson HH, Chan KA, editors. Pharmacoepidemiology and therapeutic risk management. Cincinnati: Harvey Wittheny; 2008. ISBN 978-0-929375-30-4.
World Health Organisation Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment. Oslo, Norway: WHO; 2009.
WHO Collaborating Centre for Drug Statistics methodology. ATC Index with DDD’s. Oslo: WHO; 2001.
WHO Collaborating Centre for Drug Statistics Methodology. ATC Index with DDD’s. Oslo: WHO; 2002.
WHO Collaborating Centre for Drug Statistics Methodology. ATC Index with DDD’s. Oslo: WHO; 2003.
WHO Collaborating Centre for Drug Statistics Methodology. ATC Index with DDD’s. Oslo: WHO; 2004.
WHO Collaborating Centre for Drug Statistics Methodology. ATC Index with DDD’s. Oslo: WHO; 2005.
Natsch S, Hekster YA, de Jong R, Heerdink ER, Herings RM, van der Meer JW. Application of the ATC/DDD methodology to monitor antibiotic drug use. Eur J Clin Microbiol Infect Dis. 1998;17(1):20–4.
Heerdink ER, Urquhart J, Leufkens HG. Changes in prescribed drug doses after market introduction. Pharmacoepidemiol Drug Saf. 2002;11(6):447–53.
Stolk P, Heerdink ER, Leufkens HG. Changes in the defined daily dose; YP2D6/CYP3A metabolism as an indicator for dose-setting problems. Eur J Clin Pharmacol. 2005;61(3):243–6.
Funding
This work was supported by a grant from the Ministry of Science Education and Sports, Croatia (grant No. 062-0000000-3537).
Conflicts of interest statement
Authors have no conflicts of interest to declare.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Vlahović-Palčevski, V., Gantumur, M., Radošević, N. et al. Coping with changes in the Defined Daily Dose in a longitudinal drug consumption database. Pharm World Sci 32, 125–129 (2010). https://doi.org/10.1007/s11096-010-9366-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11096-010-9366-0