gms | German Medical Science

14. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

15.11. - 16.11.2007, Frankfurt am Main

Drug treatment before and after hospitalization – an analysis of data from a statutory health insurance company

Meeting Abstract

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  • corresponding author T. Grimmsmann - MDK Mecklenburg-Vorpommern, Schwerin
  • W. Himmel - Department of General Practice, University of Göttingen

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 14. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Frankfurt am Main, 15.-16.11.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gaa17

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/gaa2007/07gaa17.shtml

Published: November 12, 2007

© 2007 Grimmsmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Context: The separation of health care in the primary and secondary sector is one factor accounting for a discontinuity in pharmacotherapy.

Aim of the study: To explore the influence of hospitalisation on the prescription of drugs in the primary care sector using prescription data of a major statutory health insurance company, with a particular focus on several drug classes, such as proton pump inhibitors (PPIs).

Material and method: We analysed drug prescriptions of patients in primary care who had been hospitalised during the first 3 months of 2005 (n=2,599 patients). The number and costs of all prescriptions of these patients 90 days before admission and after discharge, respectively, were compared.

Results: Overall costs increased after discharge by 25% and were most prominent for anti-thrombotic agents, analgetics and PPIs. The number of different active substances prescribed per patient raised by 10% from 5.3 to 5.8 per patient. Nearly all patients (2,538/2,599) were affected by changes in medication, and 50% had more than five changes, obviously initiated during hospitalisation. Of the substances prescribed to an individual before admission, 52% were cancelled after discharge, and 56% of all substances prescribed after discharge were novel prescriptions. Significantly more patients received a PPI after hospitalisation with a substantial increase especially in pantoprazol (RR for pantoprazol: 1.85; 95% CI: 1.58-2.17).

Conclusion: Hospitalisation is accompanied by changes in drug therapy for nearly every patient. Increases affect specialised therapeutics as well as on-patent drugs instead of less expensive alternatives. Outpatient prescription data may be a valid basis to monitor these drug changes and to evaluate, in due time, the effects of interventions to harmonise drug therapy between the primary and secondary sector.