Off-label use of psychotropic drugs beyond officially approved indications in Colombia

Introduction: Off-label use of psychotropic drugs is a common practice. In Colombia, no information is available in this regard.Objective. To describe off-label use of psychoactive drugs in a health promoting entity (EPS in Spanish) in Bogotá D.C.Materials and methods: Cross sectional, observational...

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Autores:
Fletscher-Covaleda, Paola Marcela
López-Gutiérrez, José Julián
Machado-Duque, Manuel
Machado-Alba, Jorge
Tipo de recurso:
Article of journal
Fecha de publicación:
2017
Institución:
Universidad Nacional de Colombia
Repositorio:
Universidad Nacional de Colombia
Idioma:
spa
OAI Identifier:
oai:repositorio.unal.edu.co:unal/65036
Acceso en línea:
https://repositorio.unal.edu.co/handle/unal/65036
http://bdigital.unal.edu.co/66059/
Palabra clave:
61 Ciencias médicas; Medicina / Medicine and health
Off-Label Use
Psychotropic Drugs
Pharmacoepidemiology
Colombia
Uso fuera de lo indicado
Psicotrópicos
Farmacoepidemiología
Colombia
Rights
openAccess
License
Atribución-NoComercial 4.0 Internacional
id UNACIONAL2_78d5a58fa4bb8221429ea0a5928d67af
oai_identifier_str oai:repositorio.unal.edu.co:unal/65036
network_acronym_str UNACIONAL2
network_name_str Universidad Nacional de Colombia
repository_id_str
dc.title.spa.fl_str_mv Off-label use of psychotropic drugs beyond officially approved indications in Colombia
title Off-label use of psychotropic drugs beyond officially approved indications in Colombia
spellingShingle Off-label use of psychotropic drugs beyond officially approved indications in Colombia
61 Ciencias médicas; Medicina / Medicine and health
Off-Label Use
Psychotropic Drugs
Pharmacoepidemiology
Colombia
Uso fuera de lo indicado
Psicotrópicos
Farmacoepidemiología
Colombia
title_short Off-label use of psychotropic drugs beyond officially approved indications in Colombia
title_full Off-label use of psychotropic drugs beyond officially approved indications in Colombia
title_fullStr Off-label use of psychotropic drugs beyond officially approved indications in Colombia
title_full_unstemmed Off-label use of psychotropic drugs beyond officially approved indications in Colombia
title_sort Off-label use of psychotropic drugs beyond officially approved indications in Colombia
dc.creator.fl_str_mv Fletscher-Covaleda, Paola Marcela
López-Gutiérrez, José Julián
Machado-Duque, Manuel
Machado-Alba, Jorge
dc.contributor.author.spa.fl_str_mv Fletscher-Covaleda, Paola Marcela
López-Gutiérrez, José Julián
Machado-Duque, Manuel
Machado-Alba, Jorge
dc.subject.ddc.spa.fl_str_mv 61 Ciencias médicas; Medicina / Medicine and health
topic 61 Ciencias médicas; Medicina / Medicine and health
Off-Label Use
Psychotropic Drugs
Pharmacoepidemiology
Colombia
Uso fuera de lo indicado
Psicotrópicos
Farmacoepidemiología
Colombia
dc.subject.proposal.spa.fl_str_mv Off-Label Use
Psychotropic Drugs
Pharmacoepidemiology
Colombia
Uso fuera de lo indicado
Psicotrópicos
Farmacoepidemiología
Colombia
description Introduction: Off-label use of psychotropic drugs is a common practice. In Colombia, no information is available in this regard.Objective. To describe off-label use of psychoactive drugs in a health promoting entity (EPS in Spanish) in Bogotá D.C.Materials and methods: Cross sectional, observational study (prescription-indication), including a random sample of patients prescribed with psychotropic drugs between January and June 2010. Sociodemographic, clinical, pharmacological and concordance variables were evaluated (correlation between use indication and approved indication). Multivariate analyzes were performed looking for an association with off-label prescriptions.Results: 420 evaluated patients had a mean age of 44.2±18.8 years, with female predominance (67.9%). Off-label prescription was found in 58.6-59.8% of cases. 84.3% of the prescriptions were delivered by general practitioners. The main psychoactive drugs prescribed for conditions such as tension headaches and insomnia were amitriptyline (n=128, 86.7% of off-label use), trazodone (n=93, 88.2%) and fluoxetine (n=66, 36.4%). The multivariate analysis found that being a young adult (OR=1.99, 95%CI: 1.06-3.70; p=0.030), being treated by general medicine (OR=3.40, 95%CI: 1.50-7.67; p=0.003) and being prescribed with amitriptyline (OR=11.38; 95%CI: 5.06-25.58; p0.001) or trazodone (OR = 13.08; 95%CI: 5.23-32.68; p0.001) increased the likelihood of receiving an off-label prescription.Conclusions: Psychotropic drugs in Bogotá are used, to a great extent, as off-label in indications other than those officially approved. Thus, it is important to strengthen education and control to achieve a rational, effective and safe use of drugs.
publishDate 2017
dc.date.issued.spa.fl_str_mv 2017-07-01
dc.date.accessioned.spa.fl_str_mv 2019-07-02T23:43:59Z
dc.date.available.spa.fl_str_mv 2019-07-02T23:43:59Z
dc.type.spa.fl_str_mv Artículo de revista
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dc.language.iso.spa.fl_str_mv spa
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dc.relation.spa.fl_str_mv https://revistas.unal.edu.co/index.php/revfacmed/article/view/57439
dc.relation.ispartof.spa.fl_str_mv Universidad Nacional de Colombia Revistas electrónicas UN Revista de la Facultad de Medicina
Revista de la Facultad de Medicina
dc.relation.references.spa.fl_str_mv Fletscher-Covaleda, Paola Marcela and López-Gutiérrez, José Julián and Machado-Duque, Manuel and Machado-Alba, Jorge (2017) Off-label use of psychotropic drugs beyond officially approved indications in Colombia. Revista de la Facultad de Medicina, 65 (3). pp. 411-415. ISSN 2357-3848
dc.rights.spa.fl_str_mv Derechos reservados - Universidad Nacional de Colombia
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.license.spa.fl_str_mv Atribución-NoComercial 4.0 Internacional
dc.rights.uri.spa.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.accessrights.spa.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv Atribución-NoComercial 4.0 Internacional
Derechos reservados - Universidad Nacional de Colombia
http://creativecommons.org/licenses/by-nc/4.0/
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eu_rights_str_mv openAccess
dc.format.mimetype.spa.fl_str_mv application/pdf
dc.publisher.spa.fl_str_mv Universidad Nacional de Colombia - Sede Bogotá - Facultad de Medicina
institution Universidad Nacional de Colombia
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repository.name.fl_str_mv Repositorio Institucional Universidad Nacional de Colombia
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spelling Atribución-NoComercial 4.0 InternacionalDerechos reservados - Universidad Nacional de Colombiahttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Fletscher-Covaleda, Paola Marcela49aee4a0-de61-4867-af64-5d4d7eb3451d300López-Gutiérrez, José Julián381697e1-7e52-41a3-9724-29ecdf7f353b300Machado-Duque, Manuel6d8ea2b7-87dd-4fd2-8fb7-eb45b810a324300Machado-Alba, Jorgec3f2d5f5-7f37-4397-ae89-23dd682d181d3002019-07-02T23:43:59Z2019-07-02T23:43:59Z2017-07-01ISSN: 2357-3848https://repositorio.unal.edu.co/handle/unal/65036http://bdigital.unal.edu.co/66059/Introduction: Off-label use of psychotropic drugs is a common practice. In Colombia, no information is available in this regard.Objective. To describe off-label use of psychoactive drugs in a health promoting entity (EPS in Spanish) in Bogotá D.C.Materials and methods: Cross sectional, observational study (prescription-indication), including a random sample of patients prescribed with psychotropic drugs between January and June 2010. Sociodemographic, clinical, pharmacological and concordance variables were evaluated (correlation between use indication and approved indication). Multivariate analyzes were performed looking for an association with off-label prescriptions.Results: 420 evaluated patients had a mean age of 44.2±18.8 years, with female predominance (67.9%). Off-label prescription was found in 58.6-59.8% of cases. 84.3% of the prescriptions were delivered by general practitioners. The main psychoactive drugs prescribed for conditions such as tension headaches and insomnia were amitriptyline (n=128, 86.7% of off-label use), trazodone (n=93, 88.2%) and fluoxetine (n=66, 36.4%). The multivariate analysis found that being a young adult (OR=1.99, 95%CI: 1.06-3.70; p=0.030), being treated by general medicine (OR=3.40, 95%CI: 1.50-7.67; p=0.003) and being prescribed with amitriptyline (OR=11.38; 95%CI: 5.06-25.58; p0.001) or trazodone (OR = 13.08; 95%CI: 5.23-32.68; p0.001) increased the likelihood of receiving an off-label prescription.Conclusions: Psychotropic drugs in Bogotá are used, to a great extent, as off-label in indications other than those officially approved. Thus, it is important to strengthen education and control to achieve a rational, effective and safe use of drugs.Introducción. El uso de psicofármacos por fuera de las indicaciones aprobadas (off-label) es una práctica común, de la cual no se tiene información en Colombia.Objetivo. Describir el uso off-label de psicofármacos en una entidad promotora de salud de Bogotá D.C.Materiales y métodos. Estudio observacional de prescripción-indicación con una muestra aleatoria de pacientes prescritos con psicofármacos entre enero y junio de 2010. Se evaluaron variables sociodemográficas, clínicas, farmacológicas y de concordancia y se realizaron análisis multivariados buscando asociación con prescripciones no aprobadas.Resultados. Los 420 pacientes evaluados tenían una edad promedio de 44.2±18.8 años, con predominio femenino (67.9%). Se encontró prescripción no aprobada en 58.6-59.8% de los casos; el 84.3% de las formulas fueron hechas por medicina general. Los principales psicofármacos en indicaciones como cefalea tensional e insomnio fueron amitriptilina (n=128; 86.7% de uso no aprobado), trazodona (n=93; 88.2%) y fluoxetina (n=66; 36.4%). En el análisis multivariado se halló que ser un adulto joven (OR=1.99; IC95%: 1.06-3.70; p=0.030), ser tratado por medicina general (OR=3.40; IC95%: 1.50-7.67; p=0.003) y ser formulado con amitriptilina (OR=11.38; IC95%: 5.06-25.58; p0.001) o trazodona (OR=13.08; IC95%: 5.23-32.68; p0.001) aumentan la probabilidad de recibir una prescripción no aprobada.Conclusiones. En la aseguradora estudiada, los psicofármacos son utilizados en una importante proporción de indicaciones no aprobadas por las autoridades regulatorias, por lo cual es importante fortalecer la educación y el control para el empleo de los medicamentos de manera racional, efectiva y segura.application/pdfspaUniversidad Nacional de Colombia - Sede Bogotá - Facultad de Medicinahttps://revistas.unal.edu.co/index.php/revfacmed/article/view/57439Universidad Nacional de Colombia Revistas electrónicas UN Revista de la Facultad de MedicinaRevista de la Facultad de MedicinaFletscher-Covaleda, Paola Marcela and López-Gutiérrez, José Julián and Machado-Duque, Manuel and Machado-Alba, Jorge (2017) Off-label use of psychotropic drugs beyond officially approved indications in Colombia. Revista de la Facultad de Medicina, 65 (3). pp. 411-415. ISSN 2357-384861 Ciencias médicas; Medicina / Medicine and healthOff-Label UsePsychotropic DrugsPharmacoepidemiologyColombiaUso fuera de lo indicadoPsicotrópicosFarmacoepidemiologíaColombiaOff-label use of psychotropic drugs beyond officially approved indications in ColombiaArtículo de revistainfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1http://purl.org/coar/version/c_970fb48d4fbd8a85Texthttp://purl.org/redcol/resource_type/ARTORIGINAL57439-358925-2-PB.pdfapplication/pdf3519282https://repositorio.unal.edu.co/bitstream/unal/65036/1/57439-358925-2-PB.pdf8eedbd1ced9392bdbc2eedb16a9c2ffcMD51THUMBNAIL57439-358925-2-PB.pdf.jpg57439-358925-2-PB.pdf.jpgGenerated Thumbnailimage/jpeg8143https://repositorio.unal.edu.co/bitstream/unal/65036/2/57439-358925-2-PB.pdf.jpgcb22666cfc4628b3c53759a82a3b6707MD52unal/65036oai:repositorio.unal.edu.co:unal/650362023-05-16 23:48:52.056Repositorio Institucional Universidad Nacional de Colombiarepositorio_nal@unal.edu.co