[Pulmonary arterial hypertension in Health District 11: a patient-oriented drug utilization analysis]. / Terapia per ipertensione arteriosa polmonare nella USL 11 di Empoli: una analisi di farmaco-utilizzazione.

Dispensing medication at the discharge of patients is an activity that allows to the Pharmacy Department to have a privileged point of view about prescribing new drugs and therapies. During last year we met several prescriptions for new drugs utilized in the treatment of pulmonary arterial hypertension (PAH), These prescriptions are the mirror of the avalaibility of new specific drugs. PAH is a rare and fatal disease; current disease-specific therapeutic interventions in PAH established pathways in disease treatment: prostacyclin, endothelin receptors antagonist. Several studies indicate that sildenafil, an oral phosphodiesterase type-5 inhibitor, may also offer benefits in the pharmacological management of PAH as well as tadalafil or vardenafil too. We collected data from our Pharmacy patient's database to evaluate the impact of this rare disease on our setting, to analyse the patterns of prescription of our physicians and to think specific health policy or pathways for the patients suffering from this disease.

Methodological issues in monitoring health services and outcomes for stroke survivors: a case study.

BACKGROUND: Obtaining comprehensive health outcomes and health services utilization data on stroke patients has been difficult. This research grew out of a memorandum of understanding between the NIH and the ISS (its Italian equivalent) to foster collaborative research on rehabilitation. OBJECTIVE: The purpose of this study was to pilot a methodology using administrative data to monitor and improve health outcomes for stroke survivors in Tuscany. METHODS: This study used qualitative and quantitative methods to study health resources available to and utilized by stroke survivors during the first 12 months post-stroke in two Italian health authorities (AUSL10 and 11). Mortality rates were used as an outcome measure. RESULTS: Number of inpatient days, number of prescriptions, and prescription costs were significantly higher for patients in AUSL 10 compared to AUSL 11. There was no significant difference between mortality rates. CONCLUSION: Using administrative data to monitor process and outcomes for chronic stroke has the potential to save money and improve outcomes. However, measures of functional impairment and more sensitive outcome measures than mortality are important. Additional recommendations for enhanced data collection and reporting are discussed.