Drug prescription for adult frequent attenders in Danish general practice: a population‐based study

Vedsted, Peter; Sørensen, Henrik Toft; Mortensen, Jens Tølbøll

doi:10.1002/pds.939

Cited by 15 publications

(20 citation statements)

References 26 publications

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“…Consequently, the use of antibiotics was not associated with lower volumes of CV drugs at the individual level as might be expected from the previous study using aggregated data [1]. This is in accordance with reported observations where patients with CV disease were likely to be frequent attenders [3] of health care centres and to receive prescriptions of antibiotics as comedication [4]. …”

supporting

confidence: 80%

Aggregated and individual pharmacy record data. Association between antibiotic and antihypertensive drug use

Nilsson¹,

Lindberg²,

Weitoft³

et al. 2008

Eur J Clin Pharmacol

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In a previous attempt to relate drug use to morbidity we compared "sickness numbers" and dispensed drug volumes in Swedish municipalities and found positive correlations between sickness numbers and dispensed volumes of most drug types. Antibiotics were an exception; higher antibiotics volumes were associated with lower sickness numbers [1].Aggregated pharmacy record data showed that municipalities with antibiotics volumes above the national average had lower volumes of cardiovascular (CV) drugs, primarily of antihypertensives [1], indicating a possible link between infection and hypertension. However, the employed aggregated pharmacy record data gave no information regarding the relation between the dispensed volumes of antibiotics and CV drugs for individuals. The present study aimed at obtaining such information.The dispensed drug volumes in Sweden (2006) in DDD of antibiotics (ATC code J01) and the CV drugs diuretics (C03), beta-blocking agents (C07), calcium antagonists (C08) and ACE-inhibitors (C09) per 10-year age groups for patients aged ≥ 40 years were extracted from the Swedish Prescribed Drug Register [2]. The number of individuals and percentages of the population with antibiotics or CV drugs were determined. The expected percentage with both antibiotics and CV drugs was calculated as the product of the proportion of the population with antibiotics times the proportion with CV drugs. The ratios of observed percentage/expected percentage were calculated for each age group.To determine if the use of antibiotics influenced the CV drug volume per individual, we compared for each age group the average volumes of CV drugs (DDDs of C03-C09) for patients with both antibiotics and CV drugs with the average volumes of CV drugs for patients with no antibiotics.The extracted data comprised 2.35 million individuals or between 347,000 and 597,000 individuals per age group. The ratios of observed/expected percentages of patients with both antibiotics and CV drugs were higher than 1 in four of the five age groups, indicating that more patients than expected had acquired both types of drugs. The average volumes of CV drugs (average DDD/patient) were 5-6% higher per patient treated with antibiotics than for those not treated with antibiotics.The present study showed that the proportion of the population with both antibiotics and CV drugs was higher than expected and that the groups of individuals treated with antibiotics on average had 5-6% higher volumes of CV drugs than those without antibiotics. Consequently, the use of antibiotics was not associated with lower volumes of CV drugs at the individual level as might be expected from the previous study using aggregated data [1]. This is in accordance with reported observations where patients with CV disease were likely to be frequent attenders [3] of health care centres and to receive prescriptions of antibiotics as comedication [4].

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supporting

confidence: 80%

Aggregated and individual pharmacy record data. Association between antibiotic and antihypertensive drug use

Nilsson¹,

Lindberg²,

Weitoft³

et al. 2008

Eur J Clin Pharmacol

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show abstract

“…In addition, costs were also generated by medicines. Frequent attenders obtained more prescriptions (Vedsted et al, 2004a;Vedsted et al, 2004b;Smits et al, 2009;Diaz et al, 2014;Pymont and Butterworth, 2015a;Pymont and Butterworth, 2015b); they especially used analgesics (Vedsted et al, 2004b;Smits et al, 2009;Patel et al, 2015), psychotropic medications (Stewart and O'Dowd, 2002;Vedsted et al, 2004b;Smits et al, 2009) and antibiotics (Bergh and Marklund, 2003;Vedsted et al, 2004b). Social disadvantages and economic costs increased long-term sick leave (Bergh et al, 2007;Jatic and Jatic, 2008;Luciano et al, 2010) and disability pensions (Jyväsjärvi et al, 2001;Bergh et al, 2006;Bergh et al, 2007) due to poor health and illness.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Frequent attenders in primary health care: A concept analysis

Kivelä

Elo

Kääriäinen

2018

International Journal of Nursing Studies

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“…Despite different definitions and high heterogeneity, FAs are characterized by increasing age, female gender, low social support, living alone, unemployment, and low income [ 1 , 7 ]. Moreover, high rates of physical and mental disease [ 1 , 7 , 8 ] multimorbidity [ 1 ], higher drug use, and polypharmacy [ 9 ] have been reported among FAs. Being a FA might be adequate if the patient needs frequent medical advice and control or to compensate for communication difficulties, but might be a sign of the patient not obtaining the expected help [ 5 , 6 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

Frequent attenders in general practice and immigrant status in Norway: A nationwide cross-sectional study

Díaz

Gimeno-Feliu

Calderón‐Larrañaga

et al. 2014

Scandinavian Journal of Primary Health Care

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Objective. To compare the likelihood of being a frequent attender (FA) to general practice among native Norwegians and immigrants, and to study socioeconomic and morbidity factors associated with being a FA for natives and immigrants. Design, setting and subjects. Linked register data for all inhabitants in Norway with at least one visit to the general practitioner (GP) in 2008 (2 967 933 persons). Immigrants were grouped according to their country of origin into low- (LIC), middle- (MIC), and high-income countries (HIC). FAs were defined as patients whose attendance rate ranked in the top 10% (cut-off point > 7 visits). Main outcome measures. FAs were compared with other GP users by means of multivariate binary logistic analyses adjusting for socioeconomic and morbidity factors. Results. Among GP users during the daytime, immigrants had a higher likelihood of being a FA compared with natives (OR (95% CI): 1.13 (1.09–1.17) and 1.15 (1.12–1.18) for HIC, 1.84 (1.78–1.89) and 1.66 (1.63–1.70) for MIC, and 1.77 (1.67–1.89) and 1.65 (1.57–1.74) for LIC for men and women respectively). Pregnancy, middle income earned in Norway, and having cardiologic and psychiatric problems were the main factors associated with being a FA. Among immigrants, labour immigrants and the elderly used GPs less often, while refugees were overrepresented among FAs. Psychiatric, gastroenterological, endocrine, and non-specific drug morbidity were relatively more prevalent among immigrant FA compared with natives. Conclusion. Although immigrants account for a small percentage of all FAs, GPs and policy-makers should be aware of differences in socioeconomic and morbidity profiles to provide equality of health care.

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Drug prescription for adult frequent attenders in Danish general practice: a population‐based study

Abstract: Frequent attendance in general practice is strongly associated with drug use and polypharmacy. FAs account for a high proportion of the prescription workload, and some disease groups are very common among FAs.

Cited by 15 publications

References 26 publications

Aggregated and individual pharmacy record data. Association between antibiotic and antihypertensive drug use

Aggregated and individual pharmacy record data. Association between antibiotic and antihypertensive drug use

Frequent attenders in primary health care: A concept analysis

Frequent attenders in general practice and immigrant status in Norway: A nationwide cross-sectional study

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