E-drug: EDL - ATC (cont'd)
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Dear E-druggers,
A coincidence that Stein raised this issue just as I am in Turkey to
try to convince them to adopt this methodology!
I fully agree with Stein. I have myself raised the issue here on
E-drug in connection with discussions about the WHO essential
drugs list and about computer software for drug management. With
little response I must admit. No literature can point to any better
methodology for statistical purposes so I cannot understand the
passivity in any other way than a general reluctance to change, cf.
efforts to have USA and UK adopt the metric system!
Having worked short-term in several Balkan countries, I have also
tried to get aid organisations working there to use it. The French
pharmacists without border have been interested, but I do not know
how far they got in modifying their software. In the Balkans it is
particularly important because it is already in use in the countries
and has been for many years. It is depressing to see stock
management lists organised by name of product and pack size and
not giving you a figure on how much you have of the substance.
Which ATC would give. And using DDD would also help you
estimate needs.
Information on ATC and DDD is not easy to obtain. The website
(www.whocc.mnd.no) does have a few pages with basic
information, but it is not actually packed with information, in
particular there is a need for practical examples. The index with the
DDDs and the book explaining the methodology are only available
for a price. I think it would be a good idea if WHO collaborating
centres would be required to publish more material online. We all
know how generous Richard Laing is in publishing all his course
material on the net. The staff at the centre in Oslo lectures quite
extensively and a course is organised in October each year in Oslo.
This course should be advertised more widely, e.g. on E-drug, and
the course material should preferably be available on the website. A
database of drug utilisation articles should also be put together and
published. The centre used to keep a database of articles, but I
think it is not done any more. I hereby challenge the centre to be
more transparent! Just because some countries' health insurance
agencies have used DDDs as recommended treatment doses does
not help in correcting that problem. I will raise the issue with
EuroDURG (www.eurodurg.org) and WHO.
I should add that the WHO collaborating centre on adverse drug
reactions monitoring is classifying the drugs according to the ATC
classification. And the WHO collaborating centre on drug utilisation
research in Stockholm, Sweden is using it in all their activities, but
should probably also be challenged to make more material available
on a website.
Lastly, in a recent meeting of the EuroDURG the idea came up that
may be substances should be given an ATC code, and may be also
a DDD, together with the INN-name. That would save time in
assigning codes and DDDs. Any E-drugger who volunteers to follow
that up?
Kirsten
Kirsten Myhr, MScPharm, MPH
Head, Eastern Region Drug Information Centre
Ulleval University Hospital
0407 Oslo, Norway
Tel.: +47 23 01 64 11(o) Fax: +47 23 01 64 10
+47 22 56 05 85 (h) mobile: +47 416 38 747
myhr@online.no (h)
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