德国曲坦类药物从处方药转向otc的公共卫生影响：系统评价和框架分析。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association Pub Date : 2025-07-25 DOI:10.1016/j.japh.2025.102489

Candice Aphroditta Imanuel MPH, Zeenah Atwan PhD, Celine Tabche MSc, PhD

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引用次数: 0

摘要

简介：偏头痛在德国是一种普遍且使人衰弱的疾病，影响了10-15%的人口。曲坦类药物是急性发作的主要治疗方法。在德国，曲坦类药物从处方药（Rx）转变为非处方药（OTC），旨在改善可及性和及时治疗。然而，它也引起了对患者安全和滥用的担忧。曲坦类药物从处方药转向非处方药的公共卫生影响仍未得到充分探讨。本研究旨在评估德国曲坦类药物从处方药转向otc的公共卫生影响。方法：根据PRISMA指南进行系统文献综述，从Embase、Medline和PubMed等数据库以及灰色文献中获取数据。研究的选择是基于与曲坦类药物从处方药转向otc的相关性及其对德国公共卫生的影响。使用covid - ence和改编自世卫组织的公共卫生影响框架进行数据提取和分析，重点关注患者相关、卫生保健系统和社会经济方面。结果：该综述确定了曲坦类药物从处方药转向otc的公共卫生益处和风险。这种转换提高了健康成年人的安全性，但由于潜在的禁忌症和不良反应，对高危人群构成了风险。它通过减轻症状、改善就业因素和增加获得治疗的机会，对与健康有关的生活质量产生积极影响。这一转变还通过将医疗保健服务从医生主导转变为药房主导和自我护理来提高护理质量，从而改善了访问和护理。在医疗保健相关方面，这种转变扩大了药剂师的作用，但对医生提出了挑战。从社会经济角度来看，这一转变节省了大量成本。结论：总体而言，德国曲坦类药物从处方药转向otc具有积极的公共卫生影响。它改善了可及性、安全性、生活质量、护理质量、药剂师的作用和社会经济效益，但对弱势群体和医生在卫生保健系统中的作用构成风险。

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The public health impact of the Rx-to-OTC switch of triptan in Germany: Systematic review and framework analysis

Background

Migraine is a prevalent and debilitating condition in Germany, affecting 10%-15% of the population. Triptans are the primary treatment for acute attacks. The switch of triptans from prescription (Rx) to over-the-counter (OTC) status in Germany aims to improve access and timely treatment. However, it also raises concerns regarding patient safety and misuse. The public health impact of the triptan Rx-to-OTC switch remains underexplored. This study aims to evaluate the public health implications of the Rx-to-OTC switch of triptans in Germany.

Objectives

Evaluate the public health implications of Rx-to-OTC switch of triptans in Germany.

Methods

A systematic literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, sourcing data from databases such as Embase, Medline, and PubMed, as well as gray literature. Studies were selected based on relevance to the Rx-to-OTC switch of triptans and its public health impact in Germany. Data extraction and analysis were performed using Covidence and a public health impact framework adapted from the World Health Organization, focusing on patient-relevant, health care system, and socioeconomic aspects.

Results

The review identified both public health benefits and risks of the Rx-to-OTC switch of triptans. The switch enhances safety for healthy adults but poses risks for high-risk individuals due to potential contraindications and adverse reactions. It positively impacts health-related quality of life by reducing symptoms, improving employment factors, and increasing access to treatment. The switch also improves quality of care by shifting healthcare delivery from physician-led to pharmacy-led and self-care, resulting in better access and care. In health care–related aspects, the switch benefits pharmacists by expanding their role but presents challenges for physicians. Socioeconomically, the switch leads to substantial cost savings.

Conclusion

Overall, the Rx-to-OTC switch of triptans in Germany has a positive public health impact. It improves access, safety, quality of life, quality of care, pharmacists' roles, and socioeconomic benefit but poses risks for vulnerable groups and physicians' roles in the health care system.

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来源期刊

Journal of the American Pharmacists Association 医学-药学

CiteScore

3.30

自引率

14.30%

发文量

336

审稿时长

46 days

期刊介绍： The Journal of the American Pharmacists Association is the official peer-reviewed journal of the American Pharmacists Association (APhA), providing information on pharmaceutical care, drug therapy, diseases and other health issues, trends in pharmacy practice and therapeutics, informed opinion, and original research. JAPhA publishes original research, reviews, experiences, and opinion articles that link science to contemporary pharmacy practice to improve patient care.