Counting drugs to understand the disease: The case of measuring the diabetes epidemic
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BioMed Central
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Counting drugs to understand the disease: The case of measuring the diabetes epidemic Henrik Støvring*1, Morten Andersen1, Henning Beck-Nielsen2, Anders Green3 and Werner Vach4 Address: 1Research Unit of General Practice, University of Southern Denmark, J.B. Winsløwsvej 9A, 5000 Odense C, Denmark, 2Diabetes Research Center, Odense University Hospital, Kløvervænget 64, 5000 Odense C, Denmark, 3Department of Epidemiology, University of Southern Denmark, J.B. Winsløwsvej 9B, 5000 Odense C, Denmark and 4Department of Statistics, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark Email: Henrik Støvring* - [email protected]; Morten Andersen - [email protected]; Henning Beck-Nielsen - [email protected]; Anders Green - [email protected]; Werner Vach - [email protected] * Corresponding author
Published: 21 February 2007 Population Health Metrics 2007, 5:2
doi:10.1186/1478-7954-5-2
Received: 29 September 2006 Accepted: 21 February 2007
This article is available from: http://www.pophealthmetrics.com/content/5/1/2 © 2007 Støvring et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Diabetes prevalence increases globally with severe consequences for afflicted individuals and societies. Data on diabetes incidence and diabetes related mortality on a population level are, however, scarce. As an alternative to dedicated studies it has been suggested to use pharmacoepidemiological databases that are readily available, at least in the Nordic countries. Methods: For all 470,000 inhabitants in Funen County, Denmark, in the period 1992–2003, data on gender, date of birth, death and migration to and from the county, and any filled prescriptions of an anti-diabetic medication was obtained from the Odense Pharmaco-Epidemiological Database. Results: Prevalence odds for use of an anti-diabetic medication rose annually 3.5% (95% confidence interval: 3.1%, 3.9%) for females, 4.5% (4.0%, 4.9%) for males. Corresponding incidence rates annually rose 4.8% (3.8%, 5.8%) for females, 4.5% (3.5%, 5.4%) for males. Mortality rates among treated annually declined 2.8% (1.4%, 4.1%) among females, 2.2% (0.9%, 3.5%) among males. The disequilibrium in absolute numbers between incidence and mortality among treated was the main driver for the increasing prevalence, while concurrent trends in incidence and diabetes related mortality only marginally affected prevalence trends. Trend estimates were insensitive to varying the length of the run-in period used for determining treatment status, except when using the naive and methodologically flawed run-in period of variable length. Conclusion: While pharmacoepidemiological databases provide a useful tool for monitoring pharmacologically treated diabetes
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