Profile, cost and pattern of prescriptions for polymedicated patients in Catalonia (Spain).

OBJECTIVES: Polypharmacy is one of the main management issues in public health policies because of its financial impact and the increasing number of people involved. The polymedicated population according to their demographic and therapeutic profile and the cost for the public healthcare system were characterised. DESIGN: Cross-sectional study. SETTING: Primary healthcare in Barcelona Health Region, Catalonia, Spain (5 105 551 inhabitants registered). PARTICIPANTS: All insured polymedicated patients. Polymedicated patients were those with a consumption of ≥16 drugs/month. MAIN OUTCOMES MEASURES: The study variables were related to age, gender and medication intake obtained from the 2008 census and records of prescriptions dispensed in pharmacies and charged to the public health system. RESULTS: There were 36 880 polymedicated patients (women: 64.2%; average age: 74.5±10.9 years). The total number of prescriptions billed in 2008 was 2 266 830 (2 272 920 total package units). The most polymedicated group (up to 40% of the total prescriptions) was patients between 75 and 84 years old. The average number of prescriptions billed monthly per patient was 32±2, with an average cost of 452.7±27.5. The total cost of those prescriptions corresponded to 2% of the drug expenditure in Catalonia. The groups N, C, A, R and M represented 71.4% of the total number of drug package units dispensed to polymedicated patients. Great variability was found between the medication profiles of men and women, and between age groups; greater discrepancies were found in paediatric patients (5-14 years) and the elderly (≥65 years). CONCLUSIONS: This study provides essential information to take steps towards rational drug use and a structured approach in the polymedicated population in primary healthcare.

2015 Iowa Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the State Hygienic Laboratory (SHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. From 1983 to 2014, this monitoring effort was known as the Regional Ambient Fish Tissue Monitoring Program (RAFT). Beginning in 2015, the only statewide fish contaminant-monitoring program in Iowa was changed to the Iowa Fish Tissue Monitoring Program (IFTMP). The IFTMP is administered by IDNR and the tissue analyses are completed at the SHL. Historically, the data generated from the IFTMP have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish-consuming Iowans (see IDNR 2006). The IFTMP incorporates five different types of monitoring sites: 1) status, 2) follow-up, 3) trend, 4) turtle, and 5) random.

2014 Iowa Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the State Hygienic Laboratory (SHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. From 1983 to 2014, this monitoring effort was known as the Regional Ambient Fish Tissue Monitoring Program (RAFT). Beginning in 2015, the only statewide fish contaminant-monitoring program in Iowa was changed to the Iowa Fish Tissue Monitoring Program (IFTMP). The IFTMP is administered by IDNR and the analyses are completed at the SHL. Historically, the data generated from the IFTMP have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish-consuming Iowans (see IDNR 2006). The IFTMP incorporates five different types of monitoring sites: 1) status, 2) follow-up, 3) trend, 4) turtle, and 5) random.

2013 Iowa Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the State Hygienic Laboratory (SHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became known as the Regional Ambient Fish Tissue Monitoring Program (RAFT). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish-consuming Iowans (see IDNR 2006). The Iowa RAFT monitoring program incorporates five different types of monitoring sites: 1) status, 2) follow-up, 3) trend, 4) turtle, and 5) random.

2012 Regional Ambient Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the State Hygienic Laboratory (SHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became known as the Regional Ambient Fish Tissue Monitoring Program (RAFT). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish-consuming Iowans (see IDNR 2006). The Iowa RAFT monitoring program incorporates five different types of monitoring sites: 1) status, 2) follow-up, 3) trend, 4) turtle, and 5) random.

2011 Regional Ambient Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the State Hygienic Laboratory (SHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became known as the Regional Ambient Fish Tissue Monitoring Program (RAFT). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish-consuming Iowans (see IDNR 2006). The Iowa RAFT monitoring program incorporates five different types of monitoring sites: 1) status, 2) trend, 3) follow-up, 4) turtle, and 5) random.

2010 Regional Ambient Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the State Hygienic Laboratory (SHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became known as the Regional Ambient Fish Tissue Monitoring Program (RAFT). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish-consuming Iowans (see IDNR 2006). The Iowa RAFT monitoring program incorporates five different types of monitoring sites: 1) status, 2) trend, 3) random, 4) follow-up and 5) turtle.

2009 Regional Ambient Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the University of Iowa Hygienic Laboratory (UHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became known as the Regional Ambient Fish Tissue Monitoring Program (RAFT). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish-consuming Iowans (see IDNR 2006). The Iowa RAFT monitoring program incorporates four different types of monitoring sites: 1) status, 2) trend, 3) random and 4) follow-up. New for 2009 was the one-time inclusion of snapping turtle tissue as part of the Iowa RAFT sampling program.

2008 Regional Ambient Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the University of Iowa Hygienic Laboratory (UHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became known as the Regional Ambient Fish Tissue Monitoring Program (RAFT). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish-consuming Iowans (see IDNR 2006). The Iowa RAFT monitoring program incorporates four different types of monitoring sites: 1) status, 2) trend, 3) random and 4) follow-up.

2006/2007 Regional Ambient Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the University of Iowa Hygienic Laboratory (UHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became known as the Regional Ambient Fish Tissue Monitoring Program (RAFT). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish-consuming Iowans (see IDNR 2006a). The Iowa RAFT monitoring program incorporates four different types of monitoring sites: 1) status, 2) trend, 3) random and 4) follow-up.

2005 Regional Ambient Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the University of Iowa Hygienic Laboratory (UHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became known as the Regional Ambient Fish Tissue Monitoring Program (the RAFT program). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish-consuming Iowans. The Iowa RAFT monitoring program incorporates three different types of monitoring sites: 1) status, 2) trend, and 3) follow-up.

2004 Regional Ambient Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the University of Iowa Hygienic Laboratory (UHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became the Regional Ambient Fish Tissue Monitoring Program (the RAFT program). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish-consuming Iowans. The Iowa RAFT monitoring program incorporates three different but equally important types of monitoring sites: 1) status, 2) trend, and 3) follow-up.

2003 Regional Ambient Fish Tissue Monitoring Program; Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the University of Iowa Hygienic Laboratory (UHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became the Regional Ambient Fish Tissue Monitoring Program (the RAFT program). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of Iowans consuming fish. The Iowa RAFT monitoring program incorporates three different but equally important types of monitoring sites: 1) status, 2) trend, and 3) follow-up.

2002 Regional Ambient Fish Tissue Monitoring Program Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the University of Iowa Hygienic Laboratory (UHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became the Regional Ambient Fish Tissue Monitoring Program (the RAFT program). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish consuming Iowans. The Iowa RAFT monitoring program incorporates three different but equally important types of monitoring sites: 1) status, 2) trend, and 3) follow-up.

2001 Regional Ambient Fish Tissue Monitoring Program; Summary of Analyses

To supplement other environmental monitoring programs and to protect the health of people consuming fish from waters within this state, the state of Iowa conducts fish tissue monitoring. Since 1980, the Iowa Department of Natural Resources (IDNR), the United States Environmental Protection Agency Region VII (U.S. EPA), and the University of Iowa Hygienic Laboratory (UHL) have cooperatively conducted annual statewide collections and analyses of fish for toxic contaminants. Beginning in 1983, this monitoring effort became the Regional Ambient Fish Tissue Monitoring Program (the RAFT program). Currently, the RAFT program is the only statewide fish contaminant-monitoring program in Iowa. Historically, the data generated from the RAFT program have enabled IDNR to document temporal changes in contaminant levels and to identify Iowa lakes and rivers where high levels of contaminants in fish potentially threaten the health of fish consuming Iowans.