Document Detail


Analysing duration of episodes of pharmacological care: an example of antidepressant use in Danish general practice.
MedLine Citation:
PMID:  16315340     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Analysing duration of treatment episodes has become a standard task in many pharmacoepidemiological studies. However, such analyses are often carried out in a rather simplistic manner and more subtle issues are often ignored. In this paper, methods of analysing duration treatment episodes beyond simple analyses allowing investigation of the risk for certain events over time are demonstrated. In particular, the use of cumulative incidence functions, cause-specific hazard functions, hazard rate models and expected mortality in analysing duration of episodes is presented. We used these statistical techniques in analysing the early treatment history of patients who started a regular treatment with antidepressant drugs in the primary health care sector in Denmark. We have extracted some important features: The risk of discontinuing and switching treatment was very high around 10 weeks after starting treatment. After discontinuing the first treatment period, many patients soon started a second treatment period depending on the duration of the first treatment period with highest risk around 10 weeks. The mortality rate among the patients in treatment was about three times higher than the expected mortality. The risk of dying immediately after stopping treatment was about twice the expected mortality. The analysis suggests that: (1) there is a critical period for a first discontinuing, switching and restarting treatment around 10 weeks, (2) the GPs prescribing habits have more influence on the patterns than patient or drug characteristics, (3) over time Danish GPs tend to prolong the duration of first treatment period and avoid longer treatment breaks.
Authors:
Anthony Gichangi; Morten Andersen; Jakob Kragstrup; Werner Vach
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pharmacoepidemiology and drug safety     Volume:  15     ISSN:  1053-8569     ISO Abbreviation:  Pharmacoepidemiol Drug Saf     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-09     Completed Date:  2006-12-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9208369     Medline TA:  Pharmacoepidemiol Drug Saf     Country:  England    
Other Details:
Languages:  eng     Pagination:  167-77     Citation Subset:  IM    
Affiliation:
Department of Statistics, University of Southern Denmark, DK-5000 Odense C, Denmark. anthony@stat.sdu.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antidepressive Agents / administration & dosage,  adverse effects
Databases, Factual
Denmark / epidemiology
Drug Utilization / statistics & numerical data*,  trends
Episode of Care*
Family Practice
Female
Humans
Incidence
Male
Middle Aged
Mortality
Patient Compliance / statistics & numerical data
Pharmacoepidemiology / methods*
Proportional Hazards Models
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antidepressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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