Article
Examples of off-label-use in general practices analysed with the patient database Disease Analyzer-mediplus
Analyse von Off-Label-Use in niedergelassenen Praxen mit der Patientendatenbank Disease Analyzer-mediplus
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Authors
Published: | October 16, 2003 |
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Outline
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Aim of the study
Prescription recommendations and behaviour in practice can be very different [Ref. 1]. A partnership between physicians in practices and IMS Health exists to develop a patient database for the analyses of a pattern of questions in health care research such as: is a medication in off-label-use?
Method
The analyses were carried out with the patient database Disease Analyzer -mediplus Germany [Ref. 2]. This database provides anonymous access to a representative panel of physicians and patients. More than 1900 medical practices including nearly 9 million patients and over 119 million prescriptions can be analysed in a cross and/or longitudinal section. In comparison to other patient databases mediplus is unique in the sense that it is the only available database with direct linking of individual diagnosis and corresponding therapy.
Results
Proton pump inhibitors (PPI) are approved for the indications ulcus and reflux but they are also off-label used for gastritis. The off-label rate varies between 30% and 40%. This global behaviour is influenced by the approval of Omeprazol for this indication. A second example shows the effect of Carvediol, which has admission for use in heart failure (24% of total number of patients), on the off-label-use of other beta-blockers in this indication (more than 10%).
Conclusion
The received results show high rates of off-label-use especially in the indications gastritis and heart failure. The used database mediplus is an ideal instrument for the enforcement of quantitative and qualitative analyses of issues in health care research as it combines all decision relevant information on physicians, patients, diagnoses and course of therapies. Behaviour patterns of prescribers such as off-label-use can be investigated and trends are pointed out very early.