Research on Drug Utilization
The research on drug consumption started in 1960 prompted by the interest in adverse drug reactions and increasing costs of medicines.
Significant differences were observed comparing drug utilization in different regions and countries. Following the identification of significant differences in antibiotic consumption across countries, in 1969 the WHO organized the first conference in Oslo to discuss differences in drug utilization.
Starting from 1980, research on drug utilization started focusing on aspects of rational drug use and the impact of the drug utilization on health economics.
In order to compare drug utilization internationally, researchers offered a new technical unit of measurement, the Agreed Daily Dose per day, which subsequently was replaced with the Defined Daily Dose (DDD) per day.
The subject of drug utilization studies includes all aspects of drug use: distribution and allocation of drugs, the process of prescribing drugs (what drugs are prescribed, why they are prescribed, whether they are prescribed according to set requirements and treatment guidelines) and the result of drug utilization (drug effectiveness, adverse drug reactions).
This subject of study can be seen as a bridge between pharmacoepidemiology and healthcare research and is closely related to clinical pharmacology. The main objective of drug utilization studies is to ensure safe and effective drug utilization.
An increasing number of drug utilization studies are published every year. If we search PubMed/Medline databases by keyword “drug utilization” there are 3,124 publications from 1970 to 1990, 13,088 publications from 1990 to 2011, and almost 30,000 publications over the past decade.
Studies of drug utilization have been carried out at the Faculty of Medicine of Vilnius University for more than 30 years.
Jolanta Gulbinovič „Vaistų suvartojimo Lietuvoje 1984-1991 metais analizė” [“Analysis of drug utilization in Lithuania in 1984–1991”] Vilnius: Vilnius University, 1993 [Biomedical Sciences, medicine (06 B); Scientific supervisor – Prof. J. Ramanauskas].
Kristina Garuolienė “Vaistų skyrimo kokybės ir efektyvumo vertinimas, naudojant valstybinės ligonių kasos informacinę sistemą” [“Using the National Health Insurance Fund for the assessment of prescribing quality and efficacy”], Vilnius: Vilnius University, 2012 [Biomedical Sciences, medicine (06 B); Scientific Supervisor – Assoc. Prof. Dr Jolanta Gulbinovič].
Ingrida Lisauskienė „Širdies ir kraujagyslių sistemą veikiančių vaistų vartojimo ir sergamumo bei mirštamumo nuo šios sistemos ligų kitimai Lietuvoje” [“Changes in the utilization of cardiovascular drugs and morbidity and mortality from cardiovascular diseases in Lithuania”], 2017 [Biomedical Sciences, medicine (06 B); Scientific Supervisor – Assoc. Prof. Dr Jolanta Gulbinovič].
Areas of research in drug utilization at the Pharmacy Centre 2020–2023 (Jolanta Gulbinovič, Indrė Trečiokienė, Kristina Garuolienė, Edita Kazėnaitė, and Bjorn Wettermark):
- Research on drug utilization for chronic diseases – continuation of research on the utilization of cardiovascular drugs: the quality of drugs for the treatment of hypertension is assessed by analysing conformity of prescribing drugs with the treatment guidelines, compliance with the medication regimen, continuity of treatment, and duration of treatment, and performing international comparative drug utilization research. Research on assessing the quality of drugs prescribed for the treatment of bronchial asthma is being conducted. International comparative research on the utilization of psychotropic drugs (antidepressants, benzodiazepines, antipsychotics) and the quality of treatment is being conducted.
Vilnius Regional Biomedical Research Ethics Committee (VPBTEK) authorisation No. 2021/2-1314-790
Vilnius Regional Biomedical Research Ethics Committee (VPBTEK) authorisation No. 2021/2-1316-792 - Research on antibiotic utilization. Since 2003, research has been conducted at Vilnius University for antibiotic utilization in infants based on information on the sale of reimbursed drugs collected from the database of the National Health Insurance Fund. Trends in antibiotic utilization in the paediatric population have also been conducted. This research in the paediatric population is very important, because children under 7 years of age constitute the largest share of the population treated with antibiotics. The health of adults depends on the quality of prescribing antibiotics to children, especially infants.
- Comparative international drug utilization research evaluating the efficacy of drug prescription for oncology patients, patients with rare diseases, and patients using insulin and research on the accessibility of biosimilar drugs are being conducted. International comparative pharmaceutical research evaluating national policies is also being conducted.
International projects:
- Cost action No OC-2019-1-24074 European Network to Advance Best practices & technoLogy on medication adherencE (ENABLE)
https://www.cost.eu/actions/CA19132/#tabs|Name:overview - International Medication Use Review (MUR) project. The project was initiated and conducted by Assoc. Prof. Dr Daisy Volmer, University of Tartu, Estonia
- The Happy Patient project https://happypatient.eu/. The Pharmacy Centre is a partner of the project partner Mano Seimos Gydytojas Clinic in Lithuania.
Publications by Academic Staff
History
The history of pharmacy studies is closely linked to the activities of the Society of Jesus (Jesuit Order) and the history of the Faculty of Medicine at Vilnius University.
- In 1662, the Society of Jesus obtained royal privilege from the king of the Polish-Lithuanian Commonwealth to teach pharmacists.
- In autumn 1785, Prof. Joseph Sartorius began to teach a course on pharmacy. Following his departure, the course was taught by Prof. Jędrzej Śniadecki (1768–1838).
- In 1804, Master of Pharmacy Johannes Friedrich Wolfgang (1775–1859), a graduate of the university was appointed as head of the University Pharmacy.
- In 1805, the Vilnius Medical Society was established; 3 of its 15 founders were pharmacists: Johannes Friedrich Wolfgang, George Gutt and Charles Wagner. The first paragraph of the statutes dated 1806 of the Vilnius Medical Society read: “The Vilnius Medical Society shall be responsible for medical, surgical and pharmacy matters. The aim of the society is to focus on the improvement of these sciences.” Joseph Frank, the founder of the Vilnius Medical Society, used to joke that a pharmacist is a combination of three professions – merchant, artist and a man of letters. The Vilnius Medical Society was among the first in Eastern Europe.
- In 1807, Johannes Friedrich Wolfgang was awarded a doctoral degree and started lecturing on pharmacology and pharmacy. Starting from 1807, pharmacists were allowed to become members of the Vilnius Medical Society. They were attributed to the scientist estate and acted in conjunction with doctors as their assistants.
- In 1816, Vilnius daily Dzienik Wileński published a report by Johannes Friedrich Wolfgang, pharmacist and professor of the Department of Pharmacology, “Historical notes on the status of pharmacy”, in which he provided a global review on pharmacy from Greek and Roman times to the 19th century, mentioning Lithuania too.
- In 1819, at the initiative of Johannes Friedrich Wolfgang, the Vilnius Medical Society established a separate pharmacy unit, thus raising the reputation of pharmacists in the eyes of the public. The pharmacy unit carried out research in the fields of botany, pharmacognosy, pharmaceutical chemistry, phytochemistry and balneology. It also improved the way medicines were made, acquired a new laboratory and production equipment or improved the old equipment; searched for expensive alternatives to foreign medicines; analyzed the quality of the raw materials for medicines and notified pharmacists of this, paid great attention to the quality of medicines, their impurities and forgeries, and sought ways to stop the counterfeiting of medicines.
- In 1820, the periodical Pamiętnik Farmaceutyczny Wileński was launched. This was the first publication of this type in the Russian Empire. About half of the magazine (160 articles) was composed of original articles; others were translations from European pharmacy magazines, mainly German and French. The content of the magazine consisted of the achievements of pharmaceutical science, history of nature, review of foreign publications on pharmacy and announcements of documents regulating medicinal activities.
- In 1831, the Faculty of Medicine became the Vilnius Academy of Medicine and Surgery. Pharmacists received further training, the course lasted three years. After passing the final examination with merit and performing practice, graduates became “provisors” and those who passed their examinations at the level of “well and satisfactorily” became “gesell” (assistants, Lith. gizelis).
- In 1842, after the closure of Vilnius University, higher education studies in pharmacy were available in other universities in Russia.
- In 2015, the pharmacy study programme was resumed at Vilnius University
- In 2018, the Pharmacy Centre, an academic division, was established at the Institute of Biomedical Sciences for the development and execution of the pharmacy study programme.
- On 22 June 2020, Master’s Degree diplomas were awarded to the first graduates of the resumed pharmacy programme at Vilnius University.