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Ordonnances Suspectes Indicateur d'Abus et de Pharmacodépendance [OSIAP] [2003314] - Project
General objectives

- To identify misused or abused marketed drugs in a standardized, reproducible et periodic way; - To elaborate a pharmacoepidemiological index allowing the evaluation of drug abuse and dependence potential; - To compare temporal and geographical trends across different countries in Europe concerning drug diversion and to assess the impact of regulatory measures on this diversion.

Strategic relevance and contribution to the public health programme

Strand 3 - Health Determinants.
Promoting health and prevent disease through addressing health determinants across all policies and activities.
Area of activity: Drug, Medication abuse.

The aim of this project was to systematise the identification, the collection and the analysis of suspect prescription forms, in order to validate a reproducible and reliable method for the assessment of the abuse potential of marketed drugs. The calculation of a diversion ratio for each drug allowed better understanding of trends in medication abuse patterns, at an European level, and also at a regional or national level.
This project fitted with the objectives of the European Commission to strengthen cohesion between states, with the availability of a permanent, reliable and comparative pharmaco-epidemiologic index of medication abuse potential. This indicator allowed to assess prospectively and permanently the impact of preventive measures (warning to prescribers or pharmacists, rules of prescription or dispensation, scheduling of drugs…). Thus, it also participated to the improvement of the rational use of medications, especially psychoactive medications with abuse potential.
Aims of the project:
• to identify in a systematic, reproducible and periodic way marketed drugs which were misuse and/or abuse
• to develop a pharmaco-epidemiologic index allowing to assess the abuse potential for a specific drug. To estimate a diversion ratio for each drug calculated at a local, regional, national and European level.
• to compare spatial and temporal trends of marketed drug diversion and to assess the impact of regulatory measures implemented to reduce this diversion.

Methods and means

This project was closely linked to the project of the former health monitoring programme EUROMEDSTAT, Italy.These two projects were seen as complimentary to each other.The project leader ensured coherence with the concept and the list of European Community Health Indicators developed by Unit SANCO C/2 (Health Information) in the framework of the ECHI 2 project.The project leader developed and maintained close co-operation with EUROSTAT, Unit D 6 (Health and Food Safety) and ensured the respect of the EUROSTAT methodological standards.
• Pharmacoepidemiological survey of the misuse or abuse of marketed drugs (drug diversion)
• Monitoring network of drug diversion from community pharmacies (directly in first line)
• Identification of suspect prescription forms according to a list of predefined falsification or suspicion criteria
• For each identified marketed drug (for each brand name, form and dosage of a drug), calculation of a "diversion ratio", defined by the number of citations for this drug divided by the sales of this drug during the same period and in the same geographical area.
• International comparison of drug diversion: comparison of different diversion ration according to time, and to geographical area (country, area, border regions).
• Trends analysis according to drug availability, rules of prescription or dispensation, and if applicable, proposal for changes in regulatory actions.

Expected outcomes period

• International comparison of observed trends in drug diversion,
• Permanent and reproducible measurement tool at Public Health authorities disposal to assess the impact of preventive measures (warning to prescribers or pharmacists, rules of prescription or dispensation, scheduling of drugs…),
• Annual report corresponding to survey periods, with top of marketed drugs involved in suspect prescription forms, specific diversion ratio (for each compound, or each brand name, or for a therapeutic or pharmacological class…), regional or national specificities,
• Diffusion at a national and European level (OEDT, EMCDDA, national drug agencies),
• Presentation in specialised meeting (CPDD: College on Problems of Drug Dependence, Addiction), and scientific publications.

Start date: 01/01/2005
End date: 01/01/2008
Duration: 36 month(s)
Current status: Finalised
Programme title: First Programme of Community action in the field of public health (2003-2008)
EC Contribution: € 420 385,00
Portfolio: Illicit drugs