Data Resource Profile: The Danish National Prescription Registry

Pottegård, Anton; Schmidt, Sigrún Alba Jóhannesdóttir; Kildemoes, Helle Wallach; Sørensen, Henrik Toft; Hallas, Jesper; Schmidt, Morten

doi:10.1093/ije/dyw213

Cited by 841 publications

(1,149 citation statements)

References 41 publications

Supporting

Mentioning

1,145

Contrasting

Unclassified

Order By: Relevance

“…Required copayments increased the likelihood of compliance,25 although non-compliance in taking the prescribed tablet dose could have masked a dose-response effect. Over-the-counter use of low dose ibuprofen accounted for 30-35% of total ibuprofen sales and 15-25% of total NSAID sales during the study period 7. As shown, misclassification of diclofenac use did not affect the results substantially.…”

Section: Discussionmentioning

confidence: 73%

“…The study had no missing data on exposure, confounders, or events. The prescription registry permitted identification of diclofenac use and is virtually complete 79. Our new user design resembled drug allocation in randomised controlled trials 24.…”

Section: Discussionmentioning

confidence: 99%

“…Our new user design resembled drug allocation in randomised controlled trials 24. Although we had to use prescription data as a proxy for actual NSAID use, we did not base drug exposure information on written prescriptions, but on actual dispensing at pharmacies 7. Required copayments increased the likelihood of compliance,25 although non-compliance in taking the prescribed tablet dose could have masked a dose-response effect.…”

Section: Discussionmentioning

confidence: 99%

“…We used the Danish National Prescription Registry to identify drug use 7. Since 1995, this registry has maintained detailed records of all prescriptions dispensed from all Danish pharmacies 7.…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Diclofenac use and cardiovascular risks: series of nationwide cohort studies

Schmidt

Sørensen

Pedersen

2018

BMJ

Self Cite

127

110

View full text Add to dashboard Cite

ObjectiveTo examine the cardiovascular risks of diclofenac initiation compared with initiation of other traditional non-steroidal anti-inflammatory drugs, initiation of paracetamol, and no initiation.DesignSeries of 252 nationwide cohort studies, each mimicking the strict design criteria of a clinical trial (emulated trial design).SettingDanish, nationwide, population based health registries (1996-2016).ParticipantsIndividuals eligible for inclusion were all adults without malignancy; schizophrenia; dementia; or cardiovascular, kidney, liver, or ulcer diseases (that is, with low baseline risk). The study included 1 370 832 diclofenac initiators, 3 878 454 ibuprofen initiators, 291 490 naproxen initiators, 764 781 healthcare seeking paracetamol initiators matched by propensity score, and 1 303 209 healthcare seeking non-initiators also matched by propensity score.Main outcome measuresCox proportional hazards regression was used to compute the intention to treat hazard ratio (as a measure of the incidence rate ratio) of major adverse cardiovascular events within 30 days of initiation.ResultsThe adverse event rate among diclofenac initiators increased by 50% compared with non-initiators (incidence rate ratio 1.5, 95% confidence interval 1.4 to 1.7), 20% compared with paracetamol or ibuprofen initiators (both 1.2, 1.1 to 1.3), and 30% compared with naproxen initiators (1.3, 1.1 to 1.5). The event rate for diclofenac initiators increased for each component of the combined endpoint (1.2 (1.1 to 1.4) for atrial fibrillation/flutter, 1.6 (1.3 to 2.0) for ischaemic stroke, 1.7 (1.4 to 2.0) for heart failure, 1.9 (1.6 to 2.2) for myocardial infarction, and 1.7 (1.4 to 2.1) for cardiac death) as well as for low doses of diclofenac, compared with non-initiators. Although the relative risk of major adverse cardiovascular events was highest in individuals with low or moderate baseline risk (that is, diabetes mellitus), the absolute risk was highest in individuals with high baseline risk (that is, previous myocardial infarction or heart failure). Diclofenac initiation also increased the risk of upper gastrointestinal bleeding at 30 days, by approximately 4.5-fold compared with no initiation, 2.5-fold compared with initiation of ibuprofen or paracetamol, and to a similar extent as naproxen initiation.ConclusionsDiclofenac poses a cardiovascular health risk compared with non-use, paracetamol use, and use of other traditional non-steroidal anti-inflammatory drugs.

show abstract

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Diclofenac use and cardiovascular risks: series of nationwide cohort studies

Schmidt

Sørensen

Pedersen

2018

BMJ

Self Cite

127

110

View full text Add to dashboard Cite

show abstract

“…As an example of registries useful for studies on drug-cancer associations, the Nordic countries (i.e., Denmark, Finland, Norway, Iceland and Sweden) have nationwide registries containing continuously updated, complete, individual-level data on, for example, prescription drugs [18,19] and incident In the United States, the introduction of drug coverage for older adults, Medicare Part D, in 2006 has facilitated use of the Medicare fee-for-service data for pharmacoepidemiological studies on cancer incidence [22,23]. The Medicare data cover inpatient (Part A) and outpatient (Part B) diagnoses and procedures, as well as prescription data at the pharmacy level (Part D).…”

Section: Considerations Regarding Data Sourcesmentioning

confidence: 99%

Considerations for Pharmacoepidemiological Studies of Drug–Cancer Associations

Pottegård

Friis

Stürmer

et al. 2018

Basic Clin Pharma Tox

Self Cite

View full text Add to dashboard Cite

In this MiniReview, we provide general considerations for the planning and conduct of pharmacoepidemiological studies of associations between drug use and cancer development. We address data sources, study design, assessment of drug exposure, ascertainment of cancer outcomes, confounder adjustment and future perspectives. Aspects of data sources include assessment of complete history of drug use and data on dose and duration of drug use, allowing estimates of cumulative exposure. Outcome data from formal cancer registries are preferable, but cancer data from other sources, for example, patient or pathology registries, medical records or claims are also suitable. The two principal designs for observational studies evaluating drug-cancer associations are the cohort and case-control designs. A key challenge in studies of drug-cancer associations is the exposure assessment due to the typically long period of cancer development. We present methods to examine early and late effects of drug use on cancer development and discuss the need for employing 'lag-time' in order to avoid reverse causation. We emphasize that a new-user study design should always be considered. We also underline the need for 'dose-response' analyses, as drug-cancer associations are likely to be dose-dependent. Generally, studies of drug-cancer associations should explore risk of site-specific cancer, rather than cancer overall. Additional differentiation may also be crucial for organ-specific cancer with various distinct histological subtypes (e.g., lung or ovary cancer). We also highlight the influence of confounding factors and discuss various methods to address confounding, while emphasizing that the choices of methods depend on the design and specific objectives of the individual study. In some studies, use of active comparator(s) may be preferable. Pharmacoepidemiological studies of drug-cancer associations are expected to evolve considerably in the coming years, due to the increasing availability of long-term data on drug exposures and cancer outcomes, the increasing conduct of multinational studies, allowing studies of rare cancers and subtypes of cancer, and methodological improvements specifically addressing cancer and other long-term outcomes.Use of prescription and over-the-counter drugs represents exogenous exposures that may result in either increase or reduction in cancer risk. Clear associations have been established for a number of drugs, for example, the preventive effect of aspirin use against colorectal cancer [1,2] or the increased risk of renal cancer with use of phenacetin [3,4]. Further, new hypotheses often arise, such as the recent concerns about carcinogenic effects of lithium [5][6][7] and pioglitazone [8][9][10][11][12]. A significant challenge in the elucidation of drug effects on cancer development is that the effects typically first become manifest several years after drug initiation. The long period of cancer development and the relatively low incidence of most individual cancer types impede the ability o...

show abstract

Association of Maternal Antidepressant Prescription During Pregnancy With Standardized Test Scores of Danish School-aged Children

Christensen

Trabjerg

Sun

et al. 2021

JAMA

View full text Add to dashboard Cite

Key PointsQuestionIs there an association between maternal antidepressant prescription during pregnancy and standardized test scores of Danish school-aged children?FindingsIn this population-based retrospective cohort study that included 575 369 public schoolchildren in Denmark, maternal antidepressant prescription during pregnancy was associated with significantly lower standardized test scores (range, 1-100) in mathematics (adjusted test score difference, −2.2) but no significant difference in language test scores (adjusted test score difference, −0.1) compared with children whose mothers did not fill prescriptions for antidepressants during pregnancy.MeaningAmong Danish public schoolchildren, maternal antidepressant prescription during pregnancy was associated with statistically significantly lower standardized test scores in mathematics that were small in magnitude and no significant difference in language test scores.

show abstract

Data Resource Profile: The Danish National Prescription Registry

Cited by 841 publications

References 41 publications

Diclofenac use and cardiovascular risks: series of nationwide cohort studies

Diclofenac use and cardiovascular risks: series of nationwide cohort studies

Considerations for Pharmacoepidemiological Studies of Drug–Cancer Associations

Association of Maternal Antidepressant Prescription During Pregnancy With Standardized Test Scores of Danish School-aged Children

Contact Info

Product

Resources

About