| A major part of the knowledge about effectiveness and side-effects of drugs becomes available after drugs are used in everyday practice. The division of pharmacoepidemiology and drug policy collects data on utilisation of drugs and their effects in large populations, and develops methods to explore this data with regard to distinct patient groups with the objective to optimise the benefit-risk profiles of drugs for specific patient groups, to quantify specific risks, and to generate rational and cost-effective drug use. New pharmacological research findings challenge accepted standards in pharmacotherapy and we find discrepancies between formal guidelines (local or national) and everyday practice. The division investigates the processes of consensus forming and the adoption of guidelines in pharmacotherapy. The results are used to develop effective approaches to implement the research findings in medical and pharmacy practice. Models of intervention are developed, implemented and evaluated in primary as well as hospital care. * Methods and techniques used. The general methodological approach of the research programme is multidisciplinary, using methods and techniques from epidemiology, social and business sciences, pharmacoeconomics and communication science. Both qualitative and quantitative approaches are used. Special attention is given to develop instruments for outcome parameters in particular disease specific indicators for rational prescribing, and pharmacoeconomic outcomes. New techniques in relational database programming and multivariate analysis as well as established programming techniques are used for analysing drug utilisation patterns in pharmacists' prescription database (InterAction database) and in computerised medical data (RNG and IPCI database). Data from this research is linked with adverse drug reaction databases and with accepted standards or guidelines. Computerised systems for prescription feedback, for cognitive feedback and for drug information, and protocols for medical and pharmaceutical care are developed in specific patient groups: chronic diseases (diabetes, asthma, kidney and cardiovascular disease, children and psychiatric patients), the elderly, and teratogenic risks of medicines. The design process of protocols starts with the analysis of drug utilisation patterns, quality of prescribing by physicians and the performance of patient counselling by physicians and pharmacists. Qualitative and quantitative methods are used in adapted models of behavioural sciences, health education and decision making. The same techniques are used to investigate the discrepancies between benefit-risk profiles of drugs, accepted standards and their application in medical and pharmacy practice. Intervention study designs are used to assess the effectiveness of protocols, both in terms of process and outcome. |
