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001-es BibID:BIBFORM067789
Első szerző:Horváth László (gyógyszerész)
Cím:Correlation between prescribed daily dose, seizure freedom and defined daily dose in antiepileptic drug treatment / Horváth László, Fekete Klára, Márton Sándor, Fekete István
Dátum:2017
Megjegyzések:Background: Although defined daily doses (DDD) for antiepileptic drugs (AED) have been assigned only in combination therapy, based on the literature, most patients take them in monotherapy. Furthermore, discrepancies between DDD and prescribed daily dose (PDD) were observed.Objective: First, to determine PDDs of AEDs and to reveal PDD/DDD ratio among seizure free vs. not seizure free patients in everyday clinical practice. Second, to test the applicability of 75% cut-off of DDD to achieve seizure freedom. Furthermore, to find out what factors might influence PDD.Setting: Outpatient data files at a Hungarian university hospital were studied.Methods: A retrospective, 20-year cross-sectional database was compiled from 1282 epileptic outpatients' files. Main outcome measure: Seizure freedom and PDD were used as outcome measures.Results: The mean DDD% of all prescribed AEDs increased steadily from monotherapy, through bitherapy towards polytherapy (p<0.0001). Most seizure free patients took AEDs in doses in the range of ?75% of DDDs in monotherapy and bitherapy. Older AEDs (carbamazepine and valproate) were prescribed in a significantly higher mean dose in bitherapy in the seizure free group. Among the newer types, only levetiracetam and lamotrigine had a significantly higher DDD% in mono-, bi-, and polytherapy. Confirmed by logistic regression analysis, gender, age, type of epilepsy, and number of AEDs had a significant impact on the value of 75% DDD.Conclusion: No significant unfavourable impact of the lower ratio of PDD/DDD on the outcome of achieving seizure freedom has been confirmed. As a measure of seizure freedom, 75% of DDD may be used, although individual therapy must be emphasised. Precisely quantified DDD would provide a more accurate calculation of other derived values.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
drug utilization review
epilepsy
PDD
DDD
Hungary
Megjelenés:International Journal of Clinical Pharmacy 37 (2017), p. 459-467. -
További szerzők:Fekete Klára (1978-) (neurológus) Márton Sándor (1965-) (matematikus) Fekete István (1951-) (neurológus, pszichiáter)
Internet cím:DOI
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