Differences in antidiabetic drug utilisation between three different health systems in the same national region

Benı́tez, Julio; Puerto, A M; Dı́az, José A.

doi:10.1007/bf00278475

Cited by 5 publications

(1 citation statement)

References 10 publications

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“…It also provides insights into the trend in consumption of these agents. Improved intercountry collaboration and related sharing of technical resources will facilitate the harmonisation of data collection efforts and the development of a standard methodology will help to improve international data on medicines consumption allowing not only useful health‐care planning but also independent, population based, health and outcomes research 34–36…”

Section: Discussionmentioning

confidence: 99%

Quality and completeness of utilisation data on biological agents across European countries: tumour necrosis factor alpha inhibitors as a case study

Hoebert

Mantel‐Teeuwisse

Dijk

et al. 2011

Pharmacoepidemiology and Drug

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Section: Discussionmentioning

confidence: 99%

Quality and completeness of utilisation data on biological agents across European countries: tumour necrosis factor alpha inhibitors as a case study

Hoebert

Mantel‐Teeuwisse

Dijk

et al. 2011

Pharmacoepidemiology and Drug

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Intercommunity variations in antidiabetic drug utilization and in prevalence of diabetes mellitus

Olsson

Tollin

Nilsson

et al. 1994

Pharmacoepidemiology and Drug

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In order to assess whether differences in the extent of antidiabetic drug utilization may be an indicator of variations in diabetes prevalence (Type 1 plus Type 2, including non-pharmacologically treated diabetics), intercommunity variations of antidiabetic drug utilization (insulin plus oral agents) in Sweden were examined through sales expressed in defined daily doses per 1000 inhabitants per day and compared with intercommunity prevalence variations. There were large (two-fold) and long-lasting (> 10 years) between-county differences in antidiabetic drug sales. Low-sales counties were found both in the doctordense south and the doctor-sparse north of Sweden, which argues against the assumption that the sales variation simply was due to different access to medical care. Recent diabetes prevalence figures have been obtained for eight municipalities in different parts of Sweden. In these, antidiabetic drug sales and diabetes prevalence (including non-pharmacologically treated diabetics) showed a close correlation (r = 0.87; p c 0.01), supporting the assumption that variations in antidiabetic drug utilization may indicate variations in diabetes prevalence, at least in countries that, like Sweden, have uniform health care systems. The findings also suggest that, in Sweden, there is little intercommunity variation in the proportion of non-pharmacologically treated diabetics. On the other hand, it is likely that there are many undetected diabetics in areas where no diabetes screening has been performed. Hence, although differences in antidiabetic drug sales may help to indicate where to look for differences in diabetes prevalence, drug sales data are no substitutes for prevalence studies.

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Are Hypoglycaemia and Other Adverse Effects Similar Among Sulphonylureas?

Salas

Jaime

2002

Adv Drug React Toxicol Rev

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This review provides an updated overview of the adverse effects of sulphonylureas and identifies factors associated with variation in adverse effect rates among sulphonylureas published by different studies. A search of Medline, Embase, Current Contents and Cochrane Library was conducted to identify all papers related to sulphonylureas and adverse effects published from 1950-2001. The reference lists of all relevant papers were also searched for additional articles. The frequency of sulphonylurea-induced hypoglycaemia varied from 1.8-59%. Severe hypoglycaemia due to sulphonylurea use has been reported from 1.9-3.5%. Variation in hypoglycaemia rates may be due to differences in definitions, methods to detect and to collect information, patient characteristics, patient knowledge of the condition, threshold for symptoms, and activity level during hypoglycaemia. Other adverse effects associated with sulphonylurea use include bodyweight gain, gastrointestinal distress, disulphiram-like syndrome, dermatological reactions, haematological changes, ocular problems, and the syndrome of inappropriate secretion of antidiuretic hormone. Bodyweight gain has been reported to vary from 1.7-4.8 kg, according to the United Kingdom Prospective Diabetes Study (UKPDS-33). Controversy exists regarding cardiovascular adverse effects, but the consensus is to exercise caution in the use of these drugs as first-line therapy for patients with diabetes mellitus and coronary artery disease. The benefits of sulphonylurea treatment should be weighed against the risks associated with them. More work in this area is needed to homogenise the definition of hypoglycaemia, to get consensus on the methods for detection and data collection, as well as to further patient and physician education.

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Differences in antidiabetic drug utilisation between three different health systems in the same national region

Cited by 5 publications

References 10 publications

Quality and completeness of utilisation data on biological agents across European countries: tumour necrosis factor alpha inhibitors as a case study

Quality and completeness of utilisation data on biological agents across European countries: tumour necrosis factor alpha inhibitors as a case study

Intercommunity variations in antidiabetic drug utilization and in prevalence of diabetes mellitus

Are Hypoglycaemia and Other Adverse Effects Similar Among Sulphonylureas?

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