Dispensing of psychotropic drugs to adults in community pharmacies in Latvia

Objective To estimate outpatient utilization of psychotropic drugs before and after pharmaceutical reform in Latvia. Setting Data concerning prescribing and dispensing of psychotropic drugs were collected in six community pharmacies in the region of Latgale of Latvia. Method An exploratory analysis of prescription data provided by six community pharmacies from 2004 to 2007. Drugs included in the study were classified according to an Anatomical-Therapeutic-Chemical (ATC) drug classification system, and ATC data were used to calculate defined daily doses (DDD) per 1,000 inhabitants. The National SSK-10 classification was used for analysis of codes of disease diagnosis. Main outcome measures Identification of the most often prescribed psychotropic drug and prescribing physician, patient characterization by age and gender, and analysis of codes of diseases. Results Benzodiazepines and benzodiazepine-related drugs were mainly prescribed in outpatient practice. Diazepam was the most frequently prescribed benzodiazepine-12 DDD/1,000/day. The drugs were prescribed mainly by family physicians (in 66% of cases). Female residents bought more psychotropic drugs than males. In addition, residents of cities bought little more drugs than those living outside urban areas. Accordingly to the recorded disease codes, the codes for neurotic and behavioral disorders dominated. Conclusion The introduction of new norms neither increased nor decreased the number of psychotropic drug prescriptions filled. The most often prescribed psychotropic drugs over 4-year period were benzodiazepines and their derivates. Disease codes on the prescriptions fully justified a reason for psychotropic drug use.