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diabetes age 15 years or older was selected from the source population. During the study years, the prevalence of type
2 diabetes increased from 4.7 to 6.0%. A significant increase in the use of antihyperglycemic therapy was also observed
between 2000 and 2003. In particular, the use of biguanides increased. During the same period, the use of sulfonylurea
monotherapy, oral combination therapy and insulin with oral combination therapy decreased. The results from the
multivariate analysis revealed that healthier patients were more likely to be prescribed biguanide and sulfonylurea
monotherapy, whereas patients with more diabetes complications and poorer glycemic control were more likely to be
prescribed oral combination therapy or insulin (monotherapy or combination therapy). In conclusion, the study results
appear to suggest that the prescribing patterns of Italian GPs and the predictors of different antihyperglycemic drug use
are consistent with recent scientific evidence.
Sacchetti E, Trifirņ G, Caputi A, Turrina C, Spina E, Cricelli C, Brignoli O, Sessa E, Mazzaglia G. Risk ofstroke with typical
and atypical anti-psychotics: a retrospective cohort study including unexposed subjects. J Psychopharmacol
2008; 22(1):39-46
ABSTRACT. The purpose of the study was to investigate the risk of stroke with typical and atypical anti-psychotics in
elderly subjects, weighting for a number of known risk factors, including dementia. Data were retrospectively drawn
from the primary care setting from the Health Search Database, which stores information on about 1.5% of the
total Italian population served by general practitioners. All elderly patients (65+ years) prescribed an anti-psychotic in
monotherapy from January 2000 to June 2003 were selected for the study. A cohort of patients not exposed to anti-
psychotics was taken from the same database. Subjects who had previously had a stroke were excluded. The main
outcome measure was the incidence of first-ever stroke during exposure to an anti-psychotic.The sample included
non-users (69,939), users of atypicals (599), butyrophenones (749), phenotiazines (907) and substituted benzamides
(1,968). The crude incidence of stroke in subjects not exposed to anti-psychotics was 12.0/1000 person-years. Risk
was significantly higher for those on butyrophenones (47.1/1000), phenotiazines (72.7/1000) and in the atypical anti-
psychotic group (47.4/1000). Substituted benzamides had an almost significant higher risk (25.0/1000). Cox regression
modelling, weighting for demographic and clinical variables with non-users as the reference group, showed that the
risk for stroke was 5.79 times for phenotiazines, 3.55 times for butyrophenones, and 2.46 times for atypicals. Clinicians
should be cautious in prescribing phenotiazines and butyrophenones in elderly patients, since the risk for stroke would
seem comparable or even greater than with atypicals.
Savica R, Beghi E, Mazzaglia G, Innocenti F, Brignoli O, Cricelli C, Caputi AP, Musolino R, Spina E, Trifiro G. Prescribing
patterns of antiepileptic drugs in Italy: a nationwide population-based study in the years 2000-2005. Eur J
Neurol 2007; 14(12):1317-21
ABSTRACT. To evaluate prevalence of use and prescribing patterns of antiepileptic drugs (AEDs) in Italian general
practice. Primary care data were obtained from the Health Search Database, a longitudinal observational database
implemented by the Italian College of General Practitioners (GPs). We selected 465 061 subjects registered by the end
of 2005 in the lists of 320 GPs, homogeneously distributed throughout Italy. Prevalence of AED use was assessed in the
entire sample and by drug type, age group, year and main geographic area (north, centre and south/islands). Overall,
24 383 subjects (5.2%) received at least one AED prescription in the study period. Prevalence of AED use (with 95%
confidence interval) increased progressively from 7.1 (6.9-7.3) in 2000 to 11.8 (11.5-12.1) in 2005 for old AEDs and
from 1.1 (1.0-1.2) to 12.2 (11.9-12.5) for new AEDs. Carbamazepine, phenobarbital and valproic acid were the most
common AEDs until 2003, when gabapentin became first. There were no differences in prescribing patterns in the three
main geographic areas. Newer AEDs were mostly used in patients aged 65 years and older. The more widespread use
of newer AEDs was for mood disorders or pain. Older AED currently remain first line drugs for epileptic disorders. An
increasing use of AEDs has been recently observed over a 6-year period in Italian general practice, mostly explained by
newer compounds used for conditions other than epilepsy.
Mantovani LG, Bettoncelli G, Cricelli C, Sessa E, Mazzaglia G, Canonica GW, Passalacqua G. Allergic rhinitis in the
Italian population evaluated through the national database of general practitioners. Allergy 2007. 62(5):569-