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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. European Journal of Clinical
Pharmacology 2005; 61(1):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 selected 465,061 individuals registered by June 2002 in the lists of 320 general practitioners,
homogeneously distributed throughout Italy, from the Health Search Database. We measured 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 schizophrenia 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.
Filippi A, Sessa E, Trifirņ G, Mazzaglia G, Pecchioli S, Caputi AP, Cricelli C. Oral anticoagulant therapy in Italy:
prescribing prevalence and clinical reasons.
Pharmacol Res 2004; 50:601-603
ABSTRACT. BACKGROUND: Oral anticoagulants (OAs) are recommended for many clinical 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 proportion to the overall
Italian population, on the basis of data from Italian Office for National 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.
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 opportunistic 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, which
collects clinical records from a representative sample of the Italian population. Clinical computerized data from 320 GPs
and 221,557 male patients were analysed. Among total requests for PSA, 3% were linked to prostate cancer, 18%
to a urological disease or symptom and 79% were not linked to any urological condition (opportunistic screening).
Opportunistic screening was used for 31.4% of subjects over 50 with a significant (P<0.0001) difference between
geographical areas (36.4% north, 33.5% central regions, 22.9% south and isles). This distribution was very similar
to prostate cancer prevalence as it resulted from the HS data. PSA testing practice showed an increase over the years
(12.7% of men over 50 in 2000, 14.3% in 2001 and 15.9% in 2002). In conclusion, the practice of opportunistic
screening of prostate cancer seems to be extensively adopted by Italian GPs and is becoming more and more popular,
although to date it is not supported by strong scientific evidence.