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

BMC Family Practice

Research Article

Jessica Skoog¹  Anders Beckman¹  Patrik Midlöv¹  Anders Halling²  Jan Sundquist³ 

[1] Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, SE-205 02, Malmö, Sweden;Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, SE-205 02, Malmö, Sweden;Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, DK-5000, Odense C, Denmark;Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, SE-205 02, Malmö, Sweden;Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA;

关键词: Prescription drug;    Pharmacological treatment;    Primary health care;    General practitioner;    Multimorbidity;    Case-mix;    Gender;    Age;    Income;    Education;    Socioeconomic status;   

DOI  :  10.1186/s12875-014-0183-8

 received in 2014-06-04, accepted in 2014-10-24,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundAge, 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.MethodData were collected on all individuals above 20 years of age in Östergötland 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.ResultsAfter 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)).ConclusionAge, 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.

【 授权许可】

CC BY   
© Skoog et al.; licensee BioMed Central Ltd. 2014