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33. Trifirņ G, Spina E, Brignoli O, Sessa E, Caputi AP, Mazzaglia G. Antipsychotic prescribing
pattern among Italian general practitioners: a population-based study during
1999-2002 years.
Eur J Clin Pharmacol. 2005;61:47-53.
ABSTRACT. OBJECTIVES: To assess the antipsychotic use and the prevalence/incidence of
antipsychotic drug users in Italy during the years 1999-2002. To estimate the persistence
with antipsychotic medications, and to measure their off-label use. METHODS: We selec-
ted 465,061 individuals registered by June 2002 in the lists of 320 general practitioners,
homogeneously distributed throughout Italy, from the Health Search Database. We measu-
red the antipsychotic drug consumption, calculated as defined daily dose (DDD) per 1000
inhabitants per day. We also calculated the number of individuals receiving at least one
antipsychotic prescription, to estimate the annual prevalence and incidence of antipsychotic
users. Among incident users, we evaluated the percentage of patients adherent to drug
label indications and the average duration of treatment, estimated as medical possession
ratio (MPR). RESULTS: Atypical antipsychotic use has continuously increased from 1999 to
2002. Women, older people and patients affected by psychotic disorders other than schizo-
phrenia were seen to be more likely to receive antipsychotic prescriptions. Persistence with
atypical drug treatment (MPR=0.213 in 2002) appeared longer than that of typical drugs
(0.169). The percentage of patients adherent to drug label indications was significantly
higher among typical antipsychotic users (P<0.001). The most common off-label use for
atypical drug was senile dementia. CONCLUSION: Atypical drug use has been continuously
expanding over the years 1999-2002, particularly in older people with dementia. The rapidly
increasing use of this new class of antipsychotics highlights the need for a better evaluation
regarding their safety profile and a better definition of their role in psychiatric treatments.
34. Filippi A, Sessa E, Trifirņ G, Mazzaglia G, Pecchioli S, Caputi AP, Cricelli C. Oral anticoa-
gulant therapy in Italy: prescribing prevalence and clinical reasons. Pharmacol Res.
ABSTRACT. BACKGROUND: Oral anticoagulants (OAs) are recommended for many clini-
cal problems and their use requires organised and knowledgeable medical support. Up to
our knowledge, there is no data about both the reasons of treatment among OAs' users
and the number of patients prescribed with OAs in Italy. OBJECTIVES: To describe the OA
use, and the reasons of prescribing among Italian General Practitioners. METHODS: We
used the Health Search Database owned by the Italian College of General Practitioners to
identify the clinical records of patients > or =20 years who had at least one prescription
of OAs during the year 2002. RESULTS: Among a study population of 448,495 patients,
3,649 subjects (0.81%) had received at least one OAs prescription. Applying such a pro-
portion to the overall Italian population, on the basis of data from Italian Office for Natio-
nal Statistics (ISTAT), we estimated that 376,882 patients would have used OAs during the
year 2002 in Italy. The most frequent clinical problem related to the use of OAs was atrial
fibrillation (45.6%), followed by cardiac valve disease (14.6%), deep vein thrombosis
(12.2%) and peripheral artery embolism (7.7%). CONCLUSIONS: Approximately 370,000
patients are prescribed with OAs in Italy and for more than 50% of them life-long therapy
is recommended. Atrial fibrillation is the most frequent reason for prescription.
35. D'Ambrosio G, Samani F, Cancian M, De Mola C. Practice of opportunistic prostate-
specific antigen screening in Italy: data from the Health Search database. Eur J
Cancer Prev. 2004;13:383-386.
ABSTRACT. The effectiveness of prostate-specific antigen (PSA) testing for opportuni-
stic screening of prostate cancer is not yet well established, although this practice seems
to be widely accepted. To estimate the opportunistic use of PSA by general practitioners
(GPs) in Italy, we conducted a survey by querying the Health Search (HS) database,