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Vol. 43. Issue 2.
Pages 73-80 (February 2007)
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Vol. 43. Issue 2.
Pages 73-80 (February 2007)
Original Articles
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Drug Prescription for Chronic Obstructive Pulmonary Disease and Asthma by Primary Care Physicians in the Spanish Autonomous Community of Madrid, 1996-2002
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Cristina Rodríguez Escolara,
Corresponding author
crodrigueze.gapm05@salud.madiid.org

Correspondence: Dra. C. Rodríguez Escolar. Servicio de Farmacia. Gerencia de Atencion Primaria Área 5. Melchor Fernández Almagro. 1. 28029 Madrid. Espańa
, Luz Fidalgo Garcíab
a Servicio de Farmacia, Gerencia de Atención Primaria Área 5, Servicio Madrileño de Salud, Madrid, Spain
b Servicio de Farmacia, Gerencia de Atención Primaria Área 8, Servicio Madrileño de Salud, Madrid, Spain
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Objective

To identify trends in the drug prescription used to treat chronic obstructive pulmonary disease (COPD) and asthma at the primary care level in Madrid between 1996 and 2002, and to assess the repercussion of new treatments.

Patients and Methods

We analyzed information on primary care general practitioners' and pediatricians' drug prescription from the R03 group (drugs for obstructive airway diseases) of the Anatomical Therapeutic Chemical Classification System. Drug consumption was measured by recording the number of packages charged to the Spanish National Health Service and dispensed in pharmacies in the Spanish autonomous community of Madrid between 1999 and 2002. Consumption was expressed as defined daily dose per 1000 inhabitants per day.

Results

Drug use expressed as defined daily dose per 1000 inhabitants per day for COPD and asthma in Madrid increased by 18.48% between 1996 and 2002. The use of inhalants increased by 33.5% over the same period. The most marked differences were the increase in the number of patients treated with selective β2 adrenergic agonists, anticholinergics, and combinations of fixed doses of long acting β2 agonists with corticosteroids. The most-used drugs in 2002 were selective β2 adrenergic agonist inhalants (37.7%), anticholinergics (22.5%), corticosteroids (19.5%), and combinations of fixed doses of long acting β2 adrenergic agonists with corticosteroids (10.5%), and xanthines (5.03%). In 2002, the prescription of 5 new treatments amounted to 15.76% of total use of COPD and asthma drugs (R03 group).

Conclusions

Drug use for obstructive diseases of the airways showed a sharp increase between 1996 and 2002. Changes in patterns of use were observed, new treatments being quickly adopted, modifying the profile of drug prescription for the management of COPD and asthma.

Key words:
Chronic Obstructive Pulmonary Disease (COPD)
Asthma
Drug use
Defined daily dose
Primary care
Objetivo

Conocer la tendencia en la utilización de los medicamentos para el tratamiento de la enfermedad pulmonar obstructiva crónica (EPOC) y el asma en atención primaria de Madrid entre 1996 y 2002, y evaluar la repercusión de las novedades terapéuticas.

Pacientes y Métodos

Se ha analizado la información sobre el consumo, en número de envases, de los medicamentos incluidos en el grupo R03 (“Medicamentos para enfermedades obstructivas de las vías aéreas”) que prescribieron médicos de familia y pediatras de atención primaria, y que, facturados con cargo al Sistema Nacional de Salud, se dispensaron en las oficinas de farmacia de la Comunidad de Madrid en el período 1996-2002. El consumo se expresa en dosis diarias definidas por 1.000 habitantes y día.

Resultados

El consumo de medicamentos, expresado en dosis diarias definidas por 1.000 habitantes y día, para la EPOC y el asma en Madrid aumentó un 18,48% entre 1996 y 2002. La utilización de la vía inhalada creció un 33,5% en dicho período. Las variaciones más destacables se centraron en el incremento del número de pacientes tratados con agonistas adrenérgicos β2 selectivos, anticolinérgicos y asociaciones a dosis fijas de agonistas β2 de acción larga con glucocorticoides. Los grupos más consumidos en 2002 fueron los agonistas adrenérgicos β2 selectivos por vía inhalada (37,7%), anticolinérgicos (22,5%), glucocorticoides (19,5%), asociaciones a dosis fijas de agonistas adrenérgicos β2 de acción larga junto con glucocorticoides (10,5%) y xantinas (5,03%). En 2002 la prescripción de 5 novedades terapéuticas generó el 15,76% del total del consumo de los fármacos utilizados en la EPOC y el asma (grupo R03).

Conclusiones

El consumo de medicamentos para enfermedades obstructivas de las vías aéreas muestra un notable crecimiento entre 1996 y 2002. Se observan cambios en los patrones de utilización, incorporándose a gran velocidad nuevas opciones terapéuticas que modifican el perfil de prescripción de los medicamentos utilizados en el manejo de la EPOC y el asma.

Palabras clave:
Enfermedad pulmonar obstructiva crónica (EPOC)
Asma
Utilización de medicamentos
Dosis diaria definida
Atención primaria
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