Marketing in the lay media and prescriptions of terbinafine in primary care: Dutch cohort study
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《英国医生杂志》
1 Department of Medical Informatics, Erasmus University Medical Center, PO Box 1738, 3000 DR Rotterdam, Netherlands, 2 Department of Epidemiology and Biostatistics, Erasmus University Medical Center, 3 Departments of Medical Informatics and Epidemiology and Biostatistics, Erasmus University Medical Center
Correspondence to: Miriam C J M Sturkenboom m.sturkenboom@erasmusmc.nl
Introduction
We retrieved all data from the integrated primary care information project—a Dutch research database for general practice—with data from a group of 150 general practitioners.4 To determine rates of prescription of terbinafine and itraconazole for onychomycosis, we counted all prescriptions (first and repeat) written for that specific indication before (1996-9) and during the campaign (2000-2) and divided these by the amount of person time in the population. We also assessed the consultation rate for new onychomycosis.
The source population comprised 470 775 patients (239 154; 50.8% males) with a total follow up of 1.5 million person years. During the study period, general practitioners issued 11 930 prescriptions for terbinafine and 10 014 prescriptions for itraconazole for onychomycosis. Before the television campaign (1996-9), the overall prescription rates of terbinafine and itraconazole were 6.50 (95% confidence interval 6.33 to 6.66) and 6.84 (6.67 to7.01) prescriptions per 1000 person years. The prescription rate of terbinafine increased from 7.7 in the month before to 15.2 (13.5 to 16.9) in the month after the launch of the campaign, and was 10.26 (9.99 to 10.53) per 1000 person years in the entire period during the campaign (2000-2). Conversely, during the campaign the prescription rate of itraconazole decreased to 6.07 (5.86 to 6.28) (figure). The consultation rate for new onychomycosis increased from 5.9 (5.6 to 6.2) in 1999 to a peak of 8.2 (7.9 to 8.6) in 2000-1 and fell to 4.9 (4.6 to 5.1) per 1000 person years in 2002.
Prescription rates and consultation rates before (1996-9) and during the campaign (2000-2) (averages are calculated per year)
Comment
Sheldon T. Dutch GPs call for ban on Novartis products. BMJ 2002;325: 355.
Br?utigam M, Nolting S, Schopf RE, Weidinger G. Randomised double blind comparison of terbinafine and itraconazole for treatment of toenail tinea infection. BMJ 1995;311: 919-22.
Nederlands Huisartsen Genootschap. Dermatomycosen (oktober 1997). http://nhg.artsennet.nl/upload/104/standaarden/M64/start.htm accessed 10 Feb 2004). (In Dutch.)
Vlug AE, van der Lei J, Mosseveld BM, van Wijk MA, van der Linden PD, Sturkenboom MC, et al. Postmarketing surveillance based on electronic patient records: the IPCI project. Methods Inf Med 1999;38: 339-44.(Geert W 't Jong, senior r)
Correspondence to: Miriam C J M Sturkenboom m.sturkenboom@erasmusmc.nl
Introduction
We retrieved all data from the integrated primary care information project—a Dutch research database for general practice—with data from a group of 150 general practitioners.4 To determine rates of prescription of terbinafine and itraconazole for onychomycosis, we counted all prescriptions (first and repeat) written for that specific indication before (1996-9) and during the campaign (2000-2) and divided these by the amount of person time in the population. We also assessed the consultation rate for new onychomycosis.
The source population comprised 470 775 patients (239 154; 50.8% males) with a total follow up of 1.5 million person years. During the study period, general practitioners issued 11 930 prescriptions for terbinafine and 10 014 prescriptions for itraconazole for onychomycosis. Before the television campaign (1996-9), the overall prescription rates of terbinafine and itraconazole were 6.50 (95% confidence interval 6.33 to 6.66) and 6.84 (6.67 to7.01) prescriptions per 1000 person years. The prescription rate of terbinafine increased from 7.7 in the month before to 15.2 (13.5 to 16.9) in the month after the launch of the campaign, and was 10.26 (9.99 to 10.53) per 1000 person years in the entire period during the campaign (2000-2). Conversely, during the campaign the prescription rate of itraconazole decreased to 6.07 (5.86 to 6.28) (figure). The consultation rate for new onychomycosis increased from 5.9 (5.6 to 6.2) in 1999 to a peak of 8.2 (7.9 to 8.6) in 2000-1 and fell to 4.9 (4.6 to 5.1) per 1000 person years in 2002.
Prescription rates and consultation rates before (1996-9) and during the campaign (2000-2) (averages are calculated per year)
Comment
Sheldon T. Dutch GPs call for ban on Novartis products. BMJ 2002;325: 355.
Br?utigam M, Nolting S, Schopf RE, Weidinger G. Randomised double blind comparison of terbinafine and itraconazole for treatment of toenail tinea infection. BMJ 1995;311: 919-22.
Nederlands Huisartsen Genootschap. Dermatomycosen (oktober 1997). http://nhg.artsennet.nl/upload/104/standaarden/M64/start.htm accessed 10 Feb 2004). (In Dutch.)
Vlug AE, van der Lei J, Mosseveld BM, van Wijk MA, van der Linden PD, Sturkenboom MC, et al. Postmarketing surveillance based on electronic patient records: the IPCI project. Methods Inf Med 1999;38: 339-44.(Geert W 't Jong, senior r)