Dispensed drugs and multiple medications in the Swedish population: an individual-based register study

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

Vad är god forskningssed? : Synpunkter, riktlinjer och exempel

Vad är god forskningssed? handlar om etiska aspekter i forskningen, och är tänkt att ge underlag för reflexion och diskussion. Den vänder sig till forskare inom alla forskningsområden, inte minst till forskarstuderande och deras handledare. Bakom skriften står tre forskare, professorerna Bengt Gustafsson, Göran Hermerén och Bo Petersson. Författarna för en grundläggande diskussion kring etiska principer som tillämpas i forskningen. De beskriver även gällande regelverk, och diskuterar uppförandepraxis som förekommer eller bör förekomma forskare emellan liksom mellan forskare och andra

Vad är god forskningssed? : Synpunkter, riktlinjer och exempel

Vad är god forskningssed? handlar om etiska aspekter i forskningen, och är tänkt att ge underlag för reflexion och diskussion. Den vänder sig till forskare inom alla forskningsområden, inte minst till forskarstuderande och deras handledare. Bakom skriften står tre forskare, professorerna Bengt Gustafsson, Göran Hermerén och Bo Petersson. Författarna för en grundläggande diskussion kring etiska principer som tillämpas i forskningen. De beskriver även gällande regelverk, och diskuterar uppförandepraxis som förekommer eller bör förekomma forskare emellan liksom mellan forskare och andra

Vad är god forskningssed? : Synpunkter, riktlinjer och exempel

Vad är god forskningssed? handlar om etiska aspekter i forskningen, och är tänkt att ge underlag för reflexion och diskussion. Den vänder sig till forskare inom alla forskningsområden, inte minst till forskarstuderande och deras handledare. Bakom skriften står tre forskare, professorerna Bengt Gustafsson, Göran Hermerén och Bo Petersson. Författarna för en grundläggande diskussion kring etiska principer som tillämpas i forskningen. De beskriver även gällande regelverk, och diskuterar uppförandepraxis som förekommer eller bör förekomma forskare emellan liksom mellan forskare och andra

Collective Identities in an Era of Transformations. Analysing Developments in East and Central Europe and the Former Soviet Union

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Acquisition cost of dispensed drugs in individuals with multiple medications--A register-based study in Sweden

Objectives To analyse the acquisition cost of dispensed prescription drugs for individuals with multiple medications in a national population.Methods We collected and analysed individual based data regarding the acquisition cost of dispensed prescription drugs for all individuals with five or more dispensed drugs (DP >= 5) in Sweden 2006 (2.2 million).Results Individuals with DP >= 5 (24.5% of the population) accounted for 78.8% of the total acquisition cost, and individuals with DP >= 10 (8.6% of the population) and DP >= 15 (3.0% of the population) accounted for 46.3% and 23.2%, respectively. The average acquisition cost per defined daily doses (DDD) generally decreased with increasing age. The highest average cost per DDD was observed for individuals with DP >= 10. The acquisition cost for women with DP >= 5 represented 56.0% of the total acquisition cost. Men with DP >= 5 represented 44.0% of the total acquisition cost.Conclusions In an entire national population, individuals with multiple medication accounted for four fifths of the total acquisition cost of dispensed drugs. Actions to reduce the number of prescription drugs for the group of patients with a number of different drugs may also result in a substantial reduction of the total acquisition cost.Acquisition cost Dispensed drugs Multiple medications Register

A cost analysis of systematic vitamin D supplementation in the elderly versus supplementation based on assessed requirements

Hypovitaminosis D is common among older people and treatment with vitamin D is associated with reduced risk of falls and fractures. This paper provides a cost analysis of assessing the vitamin D status of and providing the pharmaceuticals for elderly citizens in Kalmar County, Sweden (population approximately 230,000). Four hypothetical interventions were analyzed: (a) systematic vitamin D/calcium supplementation to all elderly (≥75 years), (b) assessment of vitamin D status in elderly and supplementation to those with insufficient levels, (c) systematic vitamin D/calcium supplementation to all nursing-home residents, and (d) assessment of vitamin D status in nursing-home residents and supplementation to those with insufficient levels. The calculations were based on an estimated reduction in overall costs due to the assessed number of hip fractures after vitamin D/calcium supplementation. The annual net economic benefit of vitamin D/calcium supplementation was estimated at (a) €304,000, (b) €860,000, (c) €755,000, and (d) €740,000. The provision of systematic vitamin D supplementation to nursing-home residents would provide a substantial net economic benefit to society and assessment of the vitamin D status before starting supplementation does not seem to be necessary. Although assessment of all elderly citizens would be more comprehensive, the true proportion with insufficient vitamin D levels in the general population is uncertain and to reaching consensus on the most advantageous daily vitamin D intake, vitamin D blood levels are necessary. Also, systematic supplementation to all elderly would result in other outcomes that could be worth the cost, but that remains to be evaluated.Betydelsen av bra D-vitaminstatus för äldres häls