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Drugs prescribed by general practitioners according to age, gender and socioeconomic status after adjustment for multimorbidity level

Berg Skoog, Jessica LU ; Midlöv, Patrik LU ; Beckman, Anders LU ; Sundquist, Jan LU and Halling, Anders LU (2014) In BMC Family Practice 15.
Abstract
Background: Age, gender and socioeconomic status have been shown to be associated with the use of prescription drugs, even after adjustment for multimorbidity. General practitioners have a holistic and patient-centred perspective and our hypothesis is that this may reflect on the prescription of drugs. In Sweden the patient may seek secondary care without a letter of referral and the liability of the prescription of drugs accompanies the patient, which makes it suitable for this type of research. In this study we examine the odds of having prescription drug use in the population and the rates of prescription drugs among patients, issued in primary health care, according to age, gender and socioeconomic status after adjustment for... (More)
Background: Age, gender and socioeconomic status have been shown to be associated with the use of prescription drugs, even after adjustment for multimorbidity. General practitioners have a holistic and patient-centred perspective and our hypothesis is that this may reflect on the prescription of drugs. In Sweden the patient may seek secondary care without a letter of referral and the liability of the prescription of drugs accompanies the patient, which makes it suitable for this type of research. In this study we examine the odds of having prescription drug use in the population and the rates of prescription drugs among patients, issued in primary health care, according to age, gender and socioeconomic status after adjustment for multimorbidity level. Method: Data were collected on all individuals above 20 years of age in Ostergotland county with about 400 000 inhabitants in year 2006. The John Hopkins ACG Case-mix was used as a proxy for multimorbidity level. Odds ratio (OR) of having prescription drugs issued in primary health care in the population and rates of prescription drug use among patients in primary health care, stated as incidence rate ratio (IRR), according to age, gender and socioeconomic status were calculated and adjusted for multimorbidity. Results: After adjustment for multimorbidity, individuals 80 years or older had higher odds ratio (OR 3.37 (CI 95% 3.22-3.52)) and incidence rate ratio (IRR 6.24 (CI 95% 5.79-6.72)) for prescription drug use. Male individuals had a lower odds ratio of having prescription drugs (OR 0.66 (CI 95% 0.64-0.69)), but among patients males had a slightly higher incidence rate of drug use (IRR 1.06 (CI 95% 1.04-1.09)). Individuals with the highest income had the lowest odds ratio of having prescription drugs and individuals with the second lowest income had the highest odds ratio of having prescription drugs (OR 1.10 (CI 95% 1.07-1.13)). Individuals with the highest education had the lowest odds ratio of having prescription drugs (OR 0.61 (CI 95% 0.54-0.67)). Conclusion: Age, gender and socioeconomic status are associated with large differences in the use of prescribed drugs in primary health care, even after adjustment for multimorbidity level. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Prescription drug, Pharmacological treatment, Primary health care, General practitioner, Multimorbidity, Case-mix, Gender, Age, Income, Education, Socioeconomic status
in
BMC Family Practice
volume
15
publisher
BioMed Central
external identifiers
  • wos:000345936900001
  • scopus:84964313652
ISSN
1471-2296
DOI
10.1186/s12875-014-0183-8
language
English
LU publication?
yes
id
a9f40ef1-4dae-4e0b-b2f7-4adafa87699f (old id 4962727)
date added to LUP
2015-02-03 07:03:48
date last changed
2017-06-25 04:11:23
@article{a9f40ef1-4dae-4e0b-b2f7-4adafa87699f,
  abstract     = {Background: Age, gender and socioeconomic status have been shown to be associated with the use of prescription drugs, even after adjustment for multimorbidity. General practitioners have a holistic and patient-centred perspective and our hypothesis is that this may reflect on the prescription of drugs. In Sweden the patient may seek secondary care without a letter of referral and the liability of the prescription of drugs accompanies the patient, which makes it suitable for this type of research. In this study we examine the odds of having prescription drug use in the population and the rates of prescription drugs among patients, issued in primary health care, according to age, gender and socioeconomic status after adjustment for multimorbidity level. Method: Data were collected on all individuals above 20 years of age in Ostergotland county with about 400 000 inhabitants in year 2006. The John Hopkins ACG Case-mix was used as a proxy for multimorbidity level. Odds ratio (OR) of having prescription drugs issued in primary health care in the population and rates of prescription drug use among patients in primary health care, stated as incidence rate ratio (IRR), according to age, gender and socioeconomic status were calculated and adjusted for multimorbidity. Results: After adjustment for multimorbidity, individuals 80 years or older had higher odds ratio (OR 3.37 (CI 95% 3.22-3.52)) and incidence rate ratio (IRR 6.24 (CI 95% 5.79-6.72)) for prescription drug use. Male individuals had a lower odds ratio of having prescription drugs (OR 0.66 (CI 95% 0.64-0.69)), but among patients males had a slightly higher incidence rate of drug use (IRR 1.06 (CI 95% 1.04-1.09)). Individuals with the highest income had the lowest odds ratio of having prescription drugs and individuals with the second lowest income had the highest odds ratio of having prescription drugs (OR 1.10 (CI 95% 1.07-1.13)). Individuals with the highest education had the lowest odds ratio of having prescription drugs (OR 0.61 (CI 95% 0.54-0.67)). Conclusion: Age, gender and socioeconomic status are associated with large differences in the use of prescribed drugs in primary health care, even after adjustment for multimorbidity level.},
  articleno    = {183},
  author       = {Berg Skoog, Jessica and Midlöv, Patrik and Beckman, Anders and Sundquist, Jan and Halling, Anders},
  issn         = {1471-2296},
  keyword      = {Prescription drug,Pharmacological treatment,Primary health care,General practitioner,Multimorbidity,Case-mix,Gender,Age,Income,Education,Socioeconomic status},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Family Practice},
  title        = {Drugs prescribed by general practitioners according to age, gender and socioeconomic status after adjustment for multimorbidity level},
  url          = {http://dx.doi.org/10.1186/s12875-014-0183-8},
  volume       = {15},
  year         = {2014},
}