Himmel, Wolfgang

[["dc.bibliographiccitation.firstpage","295"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","European Journal of Clinical Pharmacology"],["dc.bibliographiccitation.lastpage","301"],["dc.bibliographiccitation.volume","70"],["dc.contributor.author","Grimmsmann, Thomas"],["dc.contributor.author","Himmel, Wolfgang"],["dc.creator.author","Grimmsmann T"],["dc.creator.author","Himmel W"],["dc.date.accessioned","2018-11-07T09:43:28Z"],["dc.date.available","2018-11-07T09:43:28Z"],["dc.date.issued","2014"],["dc.description.abstract","To study drug persistence for antihypertensive treatment considering typical patient behaviour including extended drug holidays or irregular repeat prescriptions. We used prescription data from a German statutory health insurance to follow up patients for 4 years. Medication persistence was defined as the continued use of a specific drug class, therapy persistence as the continued use of any antihypertensive drug. We applied 2 different interval criteria within which a repeat prescription had to be issued: 180 and 360 days. A total of 9,513 patients started an antihypertensive therapy between 2006 and 2008. Applying the 180-day (360-day) interval criterion, 28 % (66 %) of the patients starting therapy with a beta-blocker were still medication-persistent after 4 years. The rates were similar for angiotensin-II receptor blockers (ARBs; 30 % and 69 % respectively) or angiotensin-converting enzyme (ACE) inhibitors (28 % and 61 % respectively). Looking at therapy persistence, these rates were 44 % (79 %) when an ACE inhibitor was the initial drug, 46 % (82 %) for ARBs. On average, even of those who were defined as therapeutically persistent with the 360 days criterion, half received a repeat prescription within 96 days, three quarters within 131 days-with a median supply of 1.2 units per day and 1.25 defined daily doses. By applying more patient-orientated criteria, we found that many patients were therapy-persistent and received a prescription at the appropriate time. Therapy persistence was nearly independent of the initial agent; thus, drug persistence may not be an argument in favour of choosing a certain drug as a first-line option."],["dc.identifier.doi","10.1007/s00228-013-1607-4"],["dc.identifier.isi","000330994200007"],["dc.identifier.pmid","24276412"],["dc.identifier.scopus","2-s2.0-84894462179"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/34194"],["dc.identifier.url","http://europepmc.org/abstract/med/24276412"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","1432-1041"],["dc.relation.issn","0031-6970"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.title","Persistence of antihypertensive drug use in German primary care: a follow-up study based on pharmacy claims data"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","783"],["dc.bibliographiccitation.issue","8"],["dc.bibliographiccitation.journal","European Journal of Clinical Pharmacology"],["dc.bibliographiccitation.lastpage","790"],["dc.bibliographiccitation.volume","63"],["dc.contributor.author","Grimmsmann, Thomas"],["dc.contributor.author","Schwabe, Ulrike"],["dc.contributor.author","Himmel, Wolfgang"],["dc.date.accessioned","2018-11-07T10:59:53Z"],["dc.date.available","2018-11-07T10:59:53Z"],["dc.date.issued","2007"],["dc.description.abstract","Objective To explore the influence of hospitalisation on the prescription of drugs in the primary care sector using prescription data of a major statutory health insurance (SHI) organisation, with a special focus on the so-called \"Me-Too\" drugs - in particular, 3-hydroxy-3-methyl-glutaryl (HMG) CoA reductase inhibitors (statins) and proton pump inhibitors (PPIs). Methods A comprehensive outpatient drug prescription analysis was conducted on members of a SHI who had been hospitalised during the first 3 months of 2004. The number and costs of all prescriptions of 2426 patients during a 3-month period before admission and after discharge, respectively, were compared using Wilcoxon's signed rank test. Data are shown in absolute and relative numbers as well as relative risks (RR) and their 95% confidence intervals (CIs). Results The total number of prescriptions before hospitalisation and after discharge remained nearly the same, while the number of different active substances prescribed per patient decreased by 4%. However, overall costs increased after discharge by 15% due to the higher cost per prescription. Changes in medication affected nearly every patient (98.1%), and 60% had at least five changes. Of the substances prescribed to an individual before admission, 57% were cancelled after discharge, and 55% of all substances prescribed after discharge were novel prescriptions. Significantly more patients received a PPI or statin after hospitalisation (RR for a PPI: 1.27; 95% CI: 1.12 -1.45; RR for a statin: 1.16; 95% CI: 1.02-1.32). The increase in PPI medication was due to a 58% increase in the number of patients receiving pantoprazole, a \"Me-Too\" drug. Conclusion Hospitalisation exerts a marked influence on drug therapy in ambulatory care, with a significant increase in the prescription of novel, on-patent drugs instead of less expensive alternatives."],["dc.identifier.doi","10.1007/s00228-007-0325-1"],["dc.identifier.isi","000247969600008"],["dc.identifier.pmid","17549465"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/50800"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","0031-6970"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.title","The influence of hospitalisation on drug prescription in primary care - a large-scale follow-up study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1206"],["dc.bibliographiccitation.issue","12"],["dc.bibliographiccitation.journal","Pharmacoepidemiology and Drug Safety"],["dc.bibliographiccitation.lastpage","1213"],["dc.bibliographiccitation.volume","18"],["dc.contributor.author","Grimmsmann, Thomas"],["dc.contributor.author","Himmel, Wolfgang"],["dc.date.accessioned","2018-11-07T11:21:44Z"],["dc.date.available","2018-11-07T11:21:44Z"],["dc.date.issued","2009"],["dc.description.abstract","Purpose To ascertain the rate and range of continuous polypharmacy in German general practices and compare practice characteristics and prescribing profiles in practices with a high rate of polypharmacy patients (HPP) and a low rate of polypharmacy patients (LPP), respectively. Methods This observational study used a database composed of prescription data from a large German statutory health insurance. We defined polypharmacy as the continuous prescription of five or more drugs and calculated the percentage of polypharmacy patients for each practice to identify HPP and LPP. Results A total of 136 521 patients in 730 general practices received continuous medication. About 10% of these patients (14 293/136 521) received five or more different drugs. HPP had, on average, 15.1% polypharmacy patients compared to 4.2% in LPP. The total number of patients attending either a HPP or LPP was comparable (437 vs. 416; p = 0.102), but HPP had a higher number of patients with prescriptions (76.9% vs. 70.8%; p < 0.0001). The patients' age distribution was similar (68.0 in LPP vs. 68.8 in RPP) and there were slightly more female, patients in LPP. Doctors in HPP prescribed proton pump inhibitors and NSAIDs more frequently than doctors in LPP, but there was no difference in the prescription of me-too drugs. Conclusion The absolute differences in age and gender distribution between HPP and LPP were modest. Prescribing quality, as measured by the rate of me-too drug prescriptions, was similar across all practices. Therefore, differences in the rate of polypharmacy in general practice cannot sufficiently be explained by these factors. Copyright (C) 2009 John Wiley & Sons, Ltd."],["dc.identifier.doi","10.1002/pds.1841"],["dc.identifier.isi","000272824200011"],["dc.identifier.pmid","19795368"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/55845"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","1053-8569"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.title","Polypharmacy in primary care practices: an analysis using a large health insurance database"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]