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Dispensed drugs and multiple medications in the Swedish population: an individual-based register study
University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.ORCID iD: 0000-0002-6648-8702
University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.ORCID iD: 0000-0002-4295-7201
2009 (English)In: BMC Clinical Pharmacology, ISSN 1472-6904, Vol. 9, no May, p. Article number: 11-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND

Multiple medications is a well-known potential risk factor in terms of patient's health. The aim of the present study was to estimate the prevalence of dispensed drugs and multiple medications in an entire national population, by using individual based data on dispensed drugs.

METHODS

Analyses of all dispensed out-patient prescriptions in 2006 from the Swedish prescribed drug register. As a cut-off for multiple medications, we applied five or more different drugs dispensed (DP >or= 5) at Swedish pharmacies for a single individual during a 3-month, a 6-month, and a 12-month study period. For comparison, results were also calculated with certain drug groups excluded.

RESULTS

6.2 million individuals received at least one dispensed drug (DP >or= 1) during 12 months in 2006 corresponding to a prevalence of 67.4%; 75.6% for females and 59.3% for males. Individuals received on average 4.7 dispensed drugs per individual (median 3, Q1-Q3 2-6); females 5.0 (median 3, Q1-Q3 2-7), males 4.3 (median 3, Q1-Q3 1-6).The prevalence of multiple medications (DP >or= 5) was 24.4% for the entire population. The prevalence increased with age. For elderly 70-79, 80-89, and 90-years, the prevalence of DP >or= 5 was 62.4, 75.1, and 77.7% in the respective age groups. 82.8% of all individuals with DP >or= 1 and 64.9% of all individuals with DP >or= 5 were < 70 years. Multiple medications was more frequent for females (29.6%) than for males (19.2%). For individuals 10 to 39 years, DP >or= 5 was twice as common among females compared to males. Sex hormones and modulators of the genital system excluded, reduced the relative risk (RR) for females vs. males for DP >or= 5 from 1.5 to 1.4. The prevalence of DP >or= 1 increased from 45.1 to 56.2 and 67.4%, respectively, when the study period was 3, 6, and 12 respectively months and the corresponding prevalence of DP >or= 5 was 11.3, 17.2, and 24.4% respectively.

CONCLUSION

The prevalence of dispensed drugs and multiple medications were extensive in all age groups and were higher for females than for males. Multiple medications should be regarded as a risk in terms of potential drug-drug interactions and adverse drug reactions in all age groups.

Place, publisher, year, edition, pages
London: BioMed Central Ltd , 2009. Vol. 9, no May, p. Article number: 11-
National Category
Information Systems
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
URN: urn:nbn:se:hik:diva-2345DOI: 10.1186/1472-6904-9-11PubMedID: 19473486OAI: oai:DiVA.org:hik-2345DiVA, id: diva2:274996
Available from: 2009-11-02 Created: 2009-11-02 Last updated: 2018-01-12Bibliographically approved
In thesis
1. On drug use, multiple medication and polypharmacy in a national population
Open this publication in new window or tab >>On drug use, multiple medication and polypharmacy in a national population
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The application of multiple medications has successively increased during a number of years and has thereby increased the potential risks of adverse drug reactions, interactions and non-adherence to drug therapy. This may result in unnecessary health expenditure, directly due to redundant drug sales, and indirectly due to the increased hospitalization caused by drug-related problems. The overall aim of this thesis was to investigate the occurrence and development of drug use, multiple medication, and polypharmacy in an entire national population by using individual-based data on dispensed drugs. The studies (I-V) in the thesis are based on data of dispensed prescription drugs for up to 6.2 million individuals obtained from the Swedish Prescribed Drug Register. The data in the studies cover different periods of time between July 2005-Sept 2008, and the data have been analyzed on the basis of epidemiological measures and statistical methods. The major conclusions of the studies are: the prevalence of dispensed drugs and multiple medications was extensive in all age groups and was higher for females than for males. Multiple medications should be regarded as a risk in terms of potential drug-drug interactions and adverse drug reactions in all age groups (I). Regional differences in the prevalence of polypharmacy were observed and partly explained by the regional age distribution in Sweden. The use of a novel weighted polypharmacy index indicated regional differences in drug therapy for individuals with polypharmacy (II). The number of drugs used by an individual not only increased the potential risks associated with multiple drug use, but also the potential burden of an increased therapeutic intensity, especially for elderly (III). Individuals with ten or more drugs accounted for almost fifty percent of the total acquisition costs of dispensed drugs. Therefore, interventions with a focus on the reduction of the number of prescription drugs for the small group of patients with a large number of different drugs may also result in a substantial reduction in the total drug costs (IV). In spite of national and regional efforts to reduce polypharmacy, the prevalence of polypharmacy and excessive polypharmacy and the mean number of drugs per individual continued to increase in Sweden 2005-2008 (V). The observed year-by-year increase in polypharmacy underlines the importance of monitoring the development of drug use in all ages. Individual-based registers studies of dispensed drugs provide high quality data and could serve as the basis for further research and also in terms of training health care personnel. It can also be used as a base for interventions and the evaluation of drug use. To enable better comparisons on drug use and its consequences, there is a need for standards concerning measurements, classification and criteria which encompass all types of medications. For clinicians, there is a need for information concerning the patient’s actual use of all different types of medications.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2010. p. 66
Series
Linnaeus University Dissertations ; 15
Keywords
drug use, multiple medication, polypharmacy, register, prevalence, therapeutic intensity, acquisition cost.
National Category
Natural Sciences
Research subject
Natural Science, Biomedical Sciences
Identifiers
urn:nbn:se:lnu:diva-2336 (URN)978-91-86491-20-8 (ISBN)
Public defence
2010-05-18, Sal N 2007, Smålandsgatan 26 B, Kalmar, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2010-04-09 Created: 2010-04-07 Last updated: 2017-05-30Bibliographically approved

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Hovstadius, BoÅstrand, BengtPetersson, Göran

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