Validity of the Finnish Prescription Register for Measuring Psychotropic Drug Exposures among Elderly Finns

Rikala, Maria; Hartikainen, Sirpa; Sulkava, Raimo; Korhonen, Maarit Jaana

doi:10.2165/11315960-000000000-00000

Cited by 81 publications

(61 citation statements)

References 35 publications

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“…Prescription Register data include dispensing of reimbursed drugs instead of actual use. However, people tend to take drugs that they regularly purchase, and the validity of pharmacy records describing actual drug exposure compared with self-reported drug use has been confirmed (Haukka et al , 2007; Rikala et al , 2010). Although the year of diagnoses is an estimate of disease stage, the lack of disease severity is a limitation in our study.…”

Section: Discussionmentioning

confidence: 99%

Antidementia drug use among community-dwelling individuals with Alzheimer’s disease in Finland

Taipale¹,

Tanskanen

Koponen³

et al. 2014

International Clinical Psychopharmacology

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The objective of this study was to investigate the prevalence of acetylcholinesterase inhibitor (AChEI) and memantine use, duration of treatment, concomitant use of these drugs, and factors associated with the discontinuation of AChEI therapy during 2006–2009. We utilized data from a nationwide sample of community-dwelling individuals with a clinically verified Alzheimer’s disease diagnosed during the year 2005 (n=6858) as a part of the MEDALZ-2005 study. During the 4-year follow-up, 84% used AChEI and 47% used memantine. Altogether, 22% of the sample used both drugs concomitantly. The median duration of the first AChEI use period was 860 (interquartile range 295–1458) days and 1103 (interquartile range 489–1487) days for the total duration of AChEI use. Although 20% of the AChEI users discontinued the use during the first year, over half of them restarted later. The risk of discontinuation was higher for rivastigmine [hazard ratio 1.34 (confidence interval 1.22–1.48)] and galantamine users [hazard ratio 1.23 (confidence interval 1.15–1.37)] compared with donepezil users in the adjusted model. In conclusion, median time for AChEI use was over 3 years and every fifth Alzheimer’s disease patient used AChEI and memantine concomitantly during the follow-up. The low rate of discontinuation is consistent with the Finnish Care Guideline but in contrast to the results reported from many other countries.

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Section: Discussionmentioning

confidence: 99%

Antidementia drug use among community-dwelling individuals with Alzheimer’s disease in Finland

Taipale¹,

Tanskanen

Koponen³

et al. 2014

International Clinical Psychopharmacology

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“…Benzodiazepine use based on data from the Prescription Register was previously validated in a populationbased intervention study. 33 Our study may underestimate benzodiazepine use, because smaller packages of these drugs were not reimbursed. We used a mathematical modelling method (PRE2DUP) to construct drug-use periods.…”

Section: Limitationsmentioning

confidence: 83%

Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease

Taipale

Tolppanen

Koponen

et al. 2017

CMAJ

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“…The hormone therapy purchase data were obtained from national registers, which include all purchased reimbursable medications. Although purchased medications may not always reflect consumed medications, our results are not prone to recall bias, and the dispensing data approximated the medication use better than prescription data [17]. One limitation of our study is the lack of data on age at menopause, but as the mean age at AD diagnosis was 80 years, it is likely that the women were mainly menopausal on the index date.…”

Section: Discussionmentioning

confidence: 99%

Systemic Estrogen Use and Discontinuation After Alzheimer’s Disease Diagnosis in Finland 2005–2012: A Nationwide Exposure-Matched Cohort Study

et al. 2018

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BackgroundIt is unknown whether cognitive status or diagnosed cognitive decline affects estrogen use.ObjectivesWe assessed how common systemic estrogen use was among community-dwellers with Alzheimer’s disease (AD) and a matched comparison cohort without AD.MethodsThis study included an exposure-matched cohort of all Finnish community-dwelling women who received a clinically verified diagnosis of AD in 2005–2011 (N = 46,116; index cases) and an equally sized matched comparison cohort without AD. Follow-up began on the matching date (date of the AD diagnosis of the index case). Data on systemic estrogen use were obtained from the prescription register. Use initiation and discontinuation were assessed.ResultsAltogether 3.1% of women with AD and 4.3% of women without AD used estrogen during the follow-up period. Only < 0.5% initiated use during the follow-up period, but 3.7% continued use until death. The prevalence of estrogen use 1 year after the AD diagnosis declined in 2005–2011.ConclusionsThere were no major differences in systemic estrogen use among Finnish women with AD when compared to those without AD. Although some persons initiated estrogen use after AD diagnosis and/or at an advanced age, the observed use patterns were mainly consistent with the current recommendations.

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Validity of the Finnish Prescription Register for Measuring Psychotropic Drug Exposures among Elderly Finns

Cited by 81 publications

References 35 publications

Antidementia drug use among community-dwelling individuals with Alzheimer’s disease in Finland

Antidementia drug use among community-dwelling individuals with Alzheimer’s disease in Finland

Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease

Systemic Estrogen Use and Discontinuation After Alzheimer’s Disease Diagnosis in Finland 2005–2012: A Nationwide Exposure-Matched Cohort Study

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