| Přispěvatelé: |
Lubbe, M.S., Kotzé, I., 10069712 - Lubbe, Martha Susanna (Supervisor), 11202203 - Kotzé, Irma (Supervisor), 10069712 - Lubbe, Martha Susanna (Supervisor)||11202203 - Kotzé, Irma (Supervisor) |
| Popis: |
MPham (Pharmacy Practice), North-West University, Potchefstroom Campus The treatment of HIV/AIDS and coexisting psychiatric disorders is critical to the wellbeing of patients. There is currently a dearth of information on the scope of prescribing of central nervous system (CNS) medication among HIV-infected individuals in the South African private health sector, specifically the medical scheme environment. The general aim of the study was to determine possible changes in the prevalence and incidence rates of HIV/AIDS, and prescribing patterns of CNS medication in HIV/AIDS patients from 1 January 2005 to 31 December 2015 in the private health sector of South Africa. Retrospective medicine claims data from a pharmaceutical benefit management (PBM) company were used. The outcomes of the study will be presented in two manuscripts. Manuscript 1 conveyed on the findings of the investigation into the trends in the incidence and prevalence rate of HIV/AIDS patients. An open cohort of all patients with a diagnosis code for HIV/AIDS (ICD-10 codes B20-B24) and who claimed antiretroviral medication was used. Both HIV/AIDS incidence and prevalence rates were measured per 1 000 medical scheme beneficiaries for each year. Data were stratified by gender, age group and province. A total of 1 213 676 and 843 972 patients claimed medicine items in 2005 and 2015, respectively. In 2005, 0.63% (n = 7 665) of patients on the PBM database were HIV/AIDS patients and 2.10% (n = 17 302) in 2015. The prevalence rate of HIV/AIDS increased 3.3 times [6.3 (2005) to 20.5 (2015) per 1 000 medical scheme beneficiaries]. The incidence rate of HIV/AIDS also increased 2.3 times from 3.9 in 2006 to 9.1 per 1 000 medical scheme beneficiaries in 2015. The prevalence rate of HIV/AIDS among females had increased by more than three times over the study period, with a prevalence rate of 20.4 per 1 000 medical scheme beneficiaries in 2015. During the same period, the incidence rate of HIV/AIDS in female patients doubled, from 4.0 per 1 000 female medical scheme beneficiaries in 2006 to 8.5 in 2015, whereas the incidence rate among males rose from 3.9 in 2006 to 9.9 per 1 000 medical scheme beneficiaries in 2015. The age group ≥40 and .05). The majority of patients received an antidepressant during 2005 (49.68%) and 2015 (73.05%), with selective serotonin re-uptake inhibitors (15.26% vs. 25.00%) as the most prescribed antidepressant sub-pharmacological group for 2010 and 2015, respectively, followed by tricyclics (14.29% vs. 19.81%) and tetracyclic antidepressants (6.82% vs. 12.99%). Amitriptyline was the most prescribed individual active ingredient prescribed in 2015 (14.61%). The prescribing of bupropion, a tetracyclic antidepressant, had increased significantly (1.3% vs. 6.82%) from 2005 to 2015 (Ρ = 0.0007). The number of patients who received a sedative hypnotic, an anxiolytic or an anti-epileptic drug also increased with 45.0%, 54.55% and 89.94%, respectively, over the study period. This study indicates various prescribing patterns of CNS medication prescribing in privatelyinsured HIV/AIDS patients, for example an increase in the prescribing of antidepressants, sedative hypnotics, anxiolytics and anti-epileptic drugs that should be further investigated. Masters |
