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Background: Concerns have been raised regarding potential increased risk of UGIT adverse effects with generic alendronate formulations.Patients and methods: In a retrospective database analysis of health resource utilization related to UGITO, we compared rates of: new use of UGIT medications (H2 blockers and proton pump inhibitors), gastroenterology specialist (GE) visits, and UGIT endoscopies, and total hospital admissions, in patients treated for > 3 months with: brand alendronate 10 mg/d (n=2875), generic 1 (Teva, Israel) 10 mg/d (n=1244), generic 2 (Unipharm, Israel) 10 mg/d (n=1088) and brand alendronate 70 mg/week (n=6893).Results: Rates of new use of UGIT medications (5.7%, 4.7%, 4.9% and 4.0% respectively) and of GE visits (0.8%, 0.7%, 0.3% and 0.8%) respectively) were not significantly different among the 4 formulations (all comparisons adjusted for age and concomitant use of NSAIDs). Endoscopies totaled 58, respective rates were 0.3%, 0.7% 1.1% and 0.4%, with generic 2 significantly higher compared to brand 70 mg/weekly, O.R. (95% CL): 3.0 (1.4-6.5). The most common findings were hiatus hernia or mild-moderate reflux esophagitis. Hospital admissions rates were not different: 4.9%, 5.2%, 4.5% and 3.6% respectively.Conclusions: Our findings, expressed in 1/4 outcome variables, indicate possible variation in patient symptoms and/or physician responses, during treatment with different generic alendronate formulations.Clinical Pharmacology & Therapeutics (2005) 79, P71–P71; doi: 10.1016/j.clpt.2005.12.258 [ABSTRACT FROM AUTHOR]

The prevalence of chronic insomnia in the adult population in Israel is 29.8%, which is comparable to other Western countries. The consequences of insomnia include fatigue, accidents, low level of well-being, and a high need for medical services. One of the well-known treatments for insomnia is sleeping pills. Physicians are educated that hypnotics are an appropriate treatment for transient insomnia but not for chronic use. It is believed that transient users are at high risk of becoming addicted to sleep medications although research has not proven this theory. NonetheLess, physicians often try to convince insomnia patients not to use these medications. In the U.S.A., only 3% of chronic insomniacs use sleep medications. There are no data on the use of sleep medications in Israel. The present study was performed using a large database comprised of 1.1 million adult patients of Maccabi Health Services. It is the first study examining sleep medication usage habits of the adult population in IsraeL. The main findings are: 2.8% of Maccabi patients use sleep medications, however only 4.5% of this group are chronic users; most chronic users started sleep medications at the age of 65 or older and they suffer more than the transient users from medical conditions such as ischemic heart disease, hypertension, and diabetes mellitus, have higher usage of antidepressant and anxiolytic medication, receive greater national financial support and are more likely to be new immigrants. The results of this study should evoke physicians to reassess their position against prescribing sleep medications to patients for whom it may help in relieving their insomnia.

Background: Bisphosphonates are effective in the prevention and treatment of osteoporosis, yet their use is suboptimal., Objectives: To measure bisphosphonate compliance among first-time users and identify factors associated with compliance., Methods: We conducted a prospective follow-up of all women aged 45+ in the second largest health management organization in Israel who were prescribed bisphosphonates for the first time. The 4448 women were classified by drug dosage. Persistence and adherence measures of compliance were calculated for each woman over a 1 year period., Results: Mean bisphosphonate persistence over a year was 216 days, with a mean medication possession ratio of 66%. Women whose medication was changed, whether from weekly to daily or daily to weekly, always had better persistence rates than those who consistently took the original dose. Persistence rates were as follows: 264 days for women who switched back and forth between daily and weekly doses, 229 days for those who switched from daily to weekly, 222 days for those who took the dosage weekly only, 191 days for those who switched to daily dosage, and 167 days for those who took the dosage daily only (P < 0.001). Switchers were also more likely to have adequate adherence rates (MPR > or = 80%): 81.3%, 76.6%, 67.5%, 61.3% and 52.2% respectively (P < 0.001). More than 20% of women stopped taking their medication within the first month. Women with higher supplemental insurance (offering significant discounts for weekly dose medications) had better persistence rates: 221 vs. 208 days (P = 0.03). Younger women and women on national pension insurance had the lowest persistence rates: 204 and 209 days respectively., Conclusions: While weekly bisphosphonate takers had better compliance rates, persistence and adherence rates were inadequate for all groups. Changing medication to meet the needs of the patient, discounting weekly medications, and providing follow-up within the first months of prescription may promote compliance.

Antibiotic treatment, day-care center (DCC) attendance and young age are associated with penicillin-non-susceptible Streptococcus pneumoniae (PNSSp) carriage. Yet, it is unclear whether each is an independent risk factor for the individual. This cross-sectional surveillance study was designed to answer this question. Nasopharyngeal cultures were obtained from 429 children (< 6 y) during a visit to the pediatrician's office. Two risk rates were calculated: the individual's absolute risk to carry PNSSp [simple odds ratio (ORS)] and the risk of an individual who is already a carrier [conditional odds ratio (ORC)]. Streptococcus pneumoniae was isolated from 52.7% of 401 children. PNSSp was detected in 37.1% of carriers. Independent risk factors were: young age [ORS 2.24, 95% confidence interval (95% CI) 1.2-4.2], DCC attendance (ORS 3.8, 95% CI 1.9-7.5), having young siblings (ORS 2.3, 95% CI 0.95-5.57) and each antibiotic treatment during the previous 3 months (ORS 1.5, 95% CI 1.25-1.85). The only significant risk factor among carriers was prior antibiotic treatment (ORC 2.24, 95% CI 1.64-3.05). Young children, who attended DCC and received 1 antibiotic course (9% of the population) had a risk 12.9 times higher than children without these features.

We assessed the prevalence of self-reported medical complaints among the community-dwelling elderly receiving regular medication, and determined associations between health and sociodemographic variables, and the prevalence of complaints. The study included 170 patients, 60-90 years of age, living at home. Participants were recruited from the 3 main primary care clinics in Rishon LeZion. All were receiving chronic medication and were followed-up utilizing a long-term medication card. Data were gathered in interviews held in patients' homes using a structured questionnaire which included sociodemographics, diseases and medication, mental state assessment by Katzman's score, and a list of 15 medical complaints common among the aged. Relations to age, gender, education, living arrangements, number of diseases and number of medications per patient were determined. Mean age of participants was 73.2 +/- 6.0 years and they suffered an average of 4.07 +/- 2.16 diseases and took 5.10 +/- 2.83 types of drugs. The most prevalent complaints were: weakness and fatigue (65.0%), agitation and restlessness (56.4%), dry mouth (45.6%), constipation (43.6%) and dizziness (43.2%). The number of diseases, gender, education and age had the strongest associations with the prevalence of specific complaints, as well as their total number. The association between number of medications and mean number of complaints was of borderline significance.