This thesis aims to demonstrate the usefulness of the General Medical Services (GMS) database to perform pharmcoepidemological studies in Ireland. The database provides information on some 30% of the population who received approximately 70% of the prescriptions. In the field of pharmacovigilence, the effects of external forces such as the media and regulatory advice are examined in relation to their effects on prescribing patterns within the GMS. Drug utilisation studies were conducted and results illustrate the extent of multiple drug use within the GMS, and indicate that the elderly population were particularly likely to be exposed to major polypharmacy. Prescribing quality was studied by applying a number of recognised and newly developed prescribing indicators to prescription. The second aim of this thesis was to determine whether material deprivation influenced prescribing patterns. It was possible to demonstrate that even within the materially deprived GMS population, that different levels of deprivation influenced prescribing patterns. In particular, the prescribing of symptomically centrally active agents e.g. benzodiazepines increased with increasing deprivation, whereas the prescription of disease specific centrally active drugs such as antidepressant therapies fell with increasing deprivation.
The GMS prescription database provided an important resource for performing studies of pharmacovigilence, drug utilisation and prescribing quality. By identifying a particular treatment and an outcome which can be measured in terms of drug therapy, it is possible to use the GMS prescription database for hypothesis testing even if one is constrained by a lack of diagnosis. Finally, the reasons for the apparent inequalities in drug prescribing with respect to material deprivation will require further study. The GMS prescription database provides an important source of prescription data for epidemiologic studies. It provides reliable data to expand the knowledge about the use and effects of drugs in the general population and could, with the appropriate safeguards and consent, be used to examine individual doctor or individual patient [prescribing in Ireland and will have an important role to play in the continues development of pharmacoepidemiology in Ireland.
|Item Type:||Thesis (PhD)|
|Notes:||Thesis only available for reference in TCD library. Thesis no. 7320|
|Accession Number:||HRB (Not in collection)|
|Subjects:||VA Geographic area > Europe > Ireland|
R Research > Data collection method
E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication)
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