[Methylphenidate prescriptions in the city of Cologne: overrepresentation of privately insured patients. Results of an analysis based on prescription data]. / Hoher Anteil privat versicherter Methylphenidat-Empfänger in Köln. Ergebnisse einer Verordnungsanalyse auf der Basis von Rezeptdaten.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a chronic psychiatric disorder which most commonly affects children and adolescents. Treatment with methylphenidate (MPH) entails a dependency risk as MPH is a psychotropic drug. In Germany, according to pharmaco-epidemiological studies based on figures provided by the general health insurance scheme, MPH prescriptions have increased 40-fold over the past decade. OBJECTIVE: We aimed to investigate MPH prescriptions issued by medical practitioners in the city of Cologne with a special focus on prescription practices and the proportion of MPH prescriptions issued for privately insured patients. METHOD: This is a descriptive study. The database consisted of all registered MPH prescriptions during the first two quarters of 2003 and included 2729 prescriptions issued by hospital and practice-based medical practitioners. RESULTS: 23% of all MPH prescriptions were issued on private prescriptions, indicating an overrepresentation of privately insured patients who generally make up about 10% of all insured persons in Germany. There was a high frequency of once-only prescriptions: 28% of all prescriptions fell into this category. In addition, prescribed daily doses were often lower or higher than age-specific recommended mean daily doses. CONCLUSION: The study provided evidence of inappropriate care patterns concerning MPH. A marked socio-economic gradient exists with regard to MPH prescriptions.

[Do local nursing home inmates get appropriate medication?--comments on the quality of drug application in nursing homes]. / Erhalten die Bewohner von Pflegeheimen vor Ort die richtigen Arzneimittel?--Zur Qualität beim Stellen von Arzneimitteln in Pflegeheimen.

BACKGROUND: Preparing prescribed drugs in unit dose systems for often multimorbid patients in nursing homes is a responsible and difficult task for the nursing personnel. The aim of this study was to increase the knowledge on the quality level of drug supply. METHOD: In a non-representative sample the local inspectorates for pharmacies in North Rhine-Westphalia compared the actually available drugs with the prescribed drugs documented in nursing homes. Participation was voluntary. RESULTS: In 50 % of the investigated nursing homes no medication error could be found. 30 percent of the observed cases showed only one error. In 20 percent the individual preparation of drugs in unit dose systems should be improved. Nursing homes with specific quality standards showed the least number of errors. Oral and not documented arrangements seem to be a common cause for avoidable errors.

[Drug supply to nursing homes for the aged]. / Arzneimittelversorgung in Alten- und Pflegeheimen - Chancen durch zukünftige Versorgungsverträge zwischen Heimen und Apotheken -

BACKGROUND: The Federal Government of Germany intends to revise the relevant legislation for pharmacies to improve supply of medicines for inhabitants of nursing homes. According to this initiative pharmacies would sign agreements with nursing homes determining the supply order, service and quality of supply. Today, such a contract is prohibited on the basis of current legislation. The local inspectorates for pharmacies in North Rhine-Westphalia checked on the current supply and initiated an investigation. METHOD: The local inspectorates for pharmacies performed structured interviews with senior managements of 35 nursing homes in four cities of North Rhine-Westphalia focussing on service and quality of supply of drugs by pharmacies. RESULTS: 80 % of nursing homes were content with the regular service provided by retail pharmacies today. Additional information and consultation by pharmacists for managements, inhabitants and nurses about drug use is only provided in special cases, e. g. after detailed requests. CONCLUSIONS: To improve drug safety in nursing homes, it makes sense and it is necessary to revise the legislation for pharmacies and to make contracts possible in which the extent of service provided is laid down. Information, consultation and inspection of drug storage should be an essential part of future contracts.

[Drug advertising--users want information. Report of telephone survey conducted by North-Rhine Westphalia Public Health Service on the topic of drug advertising and drug information for users]. / Arzneimittelwerbung--Verbraucher wollen Information. Bericht über eine vom Landesinstitut für den Offentlichen Gesundheitsdienst des Landes Nordrhein-Westfalen (lögd) durchgeführte telefonische Befragung zum Thema Arzneimittelwerbung und Arzneimittelinformation für Verbraucher.

In Germany, drug advertising of non-prescription drugs is a controversial subject. On the one hand, consumer organisations plead for placing a ban on advertising or at least to offer a detailed description of medical risks in respect of protection. On the other hand, the pharmaceutical industry is keen on liberalizing the specific advertising law for drugs. A representative telephone survey among the population of North Rhine-Westphalia was conducted in April and May 1999. It showed consumer interest in advertising, the value of information on risks, the institution with maximum credibility in drug information for consumers, the importance of the now obligatory sentence after every advertisement: Regarding risks and side effects read the leaflet in the package and ask your physician or pharmacist, and to what extend the consumer would take advice from independent experts over the telephone about drugs. It was found that, in particular women, about 30% are occasionally interested in advertising, younger people are more open-minded about advertising than older people; and that doctors and pharmacists have the most credibility and are consulted for further information. It was also found that more than 80% of the population demanded precise information on the side effects of drugs. One-third of the consumers declared that the obligatory sentence (see above) led to greater demand for information from doctors or to read attentively the instruction leaflet. Nevertheless, there is a need for more information from more than half of the consumers, who would take advantage of an independent advice centre if this should exist.