Consuelo Huerta1, Victoria Abbing-Karahagopian2, Gema Requena3, Belén Oliva1, Yolanda Alvarez4, Helga Gardarsdottir2,5, Montserrat Miret6, Cornelia Schneider7, Miguel Gil1, Patrick C Souverein2, Marie L De Bruin2, Jim Slattery4, Mark C H De Groot2, Ulrik Hesse8, Marietta Rottenkolber9, Sven Schmiedl10,11, Dolores Montero1, Andrew Bate12, Ana Ruigomez13, Luis Alberto García-Rodríguez13, Saga Johansson14, Frank de Vries2,15,16, Raymond G Schlienger17, Robert F Reynolds18, Olaf H Klungel2,19, Francisco José de Abajo3,20. 1. Division of Pharmacoepidemiology and Pharmacovigilance, Medicines for Human Use Department, Spanish Agency for Medicines and Medical Devices (AEMPS), Madrid, Spain. 2. Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands. 3. Pharmacology Unit, Department of Biomedical Sciences II, School of Medicine and Health Sciences, University of Alcalá, Madrid, Spain. 4. European Medicines Agency (EMA), London, UK. 5. Department of Clinical Pharmacy, Division Laboratory and Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands. 6. Merck KGaA, Geneva, Switzerland. 7. Division Clinical Pharmacy and Epidemiology, University of Basel, Switzerland. 8. National Institute for Health Data and Disease Control, Copenhagen, Denmark. 9. Institute for Medical Information Sciences, Epidemiology, and Biometry, Ludwig-Maximilians-Universitaet München, Munich, Germany. 10. Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany. 11. Philipp Klee-Institute for Clinical Pharmacology, HELIOS Clinic Wuppertal, Wuppertal, Germany. 12. Epidemiology, Pfizer Ltd, Tadworth, UK. 13. Spanish Center for Pharmacoepidemiological Research (CEIFE), Madrid, Spain. 14. AstraZeneca R&D, Mölndal, Sweden. 15. MRC Epidemiology Resource Centre, Southampton General Hospital, Southampton, UK. 16. School CAPHRI, Maastricht University, The Netherlands. 17. Quantitative Safety and Epidemiology, Novartis Pharma AG, Basel, Switzerland. 18. Epidemiology, Pfizer Research & Development, New York, USA. 19. University Medical Center Utrecht (UMCU), Julius Center for Health Sciences and Primary Care, The Netherlands. 20. Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Madrid, Spain.
Abstract
PURPOSE: Studies on drug utilization usually do not allow direct cross-national comparisons because of differences in the respective applied methods. This study aimed to compare time trends in BZDs prescribing by applying a common protocol and analyses plan in seven European electronic healthcare databases. METHODS: Crude and standardized prevalence rates of drug prescribing from 2001-2009 were calculated in databases from Spain, United Kingdon (UK), The Netherlands, Germany and Denmark. Prevalence was stratified by age, sex, BZD type [(using ATC codes), i.e. BZD-anxiolytics BZD-hypnotics, BZD-related drugs and clomethiazole], indication and number of prescription. RESULTS: Crude prevalence rates of BZDs prescribing ranged from 570 to 1700 per 10,000 person-years over the study period. Standardization by age and sex did not substantially change the differences. Standardized prevalence rates increased in the Spanish (+13%) and UK databases (+2% and +8%) over the study period, while they decreased in the Dutch databases (-4% and -22%), the German (-12%) and Danish (-26%) database. Prevalence of anxiolytics outweighed that of hypnotics in the Spanish, Dutch and Bavarian databases, but the reverse was shown in the UK and Danish databases. Prevalence rates consistently increased with age and were two-fold higher in women than in men in all databases. A median of 18% of users received 10 or more prescriptions in 2008. CONCLUSION: Although similar methods were applied, the prevalence of BZD prescribing varied considerably across different populations. Clinical factors related to BZDs and characteristics of the databases may explain these differences.
PURPOSE: Studies on drug utilization usually do not allow direct cross-national comparisons because of differences in the respective applied methods. This study aimed to compare time trends in BZDs prescribing by applying a common protocol and analyses plan in seven European electronic healthcare databases. METHODS: Crude and standardized prevalence rates of drug prescribing from 2001-2009 were calculated in databases from Spain, United Kingdon (UK), The Netherlands, Germany and Denmark. Prevalence was stratified by age, sex, BZD type [(using ATC codes), i.e. BZD-anxiolytics BZD-hypnotics, BZD-related drugs and clomethiazole], indication and number of prescription. RESULTS: Crude prevalence rates of BZDs prescribing ranged from 570 to 1700 per 10,000 person-years over the study period. Standardization by age and sex did not substantially change the differences. Standardized prevalence rates increased in the Spanish (+13%) and UK databases (+2% and +8%) over the study period, while they decreased in the Dutch databases (-4% and -22%), the German (-12%) and Danish (-26%) database. Prevalence of anxiolytics outweighed that of hypnotics in the Spanish, Dutch and Bavarian databases, but the reverse was shown in the UK and Danish databases. Prevalence rates consistently increased with age and were two-fold higher in women than in men in all databases. A median of 18% of users received 10 or more prescriptions in 2008. CONCLUSION: Although similar methods were applied, the prevalence of BZD prescribing varied considerably across different populations. Clinical factors related to BZDs and characteristics of the databases may explain these differences.
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