Document Detail


Changing patterns of secondary preventive medication among newly diagnosed coronary heart disease patients with diabetes in Finland: a register-based study.
MedLine Citation:
PMID:  20228159     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Information on medicine use among coronary heart disease (CHD) patients with diabetes in unselected patient populations is scarce. This study examines the use of medication to prevent new cardiac events among newly diagnosed CHD patients with diabetes comparing them to patients without diabetes and examines socioeconomic differences in medicine use in these patient groups. METHODS: Data on CHD patients (43,501 men and 31,125 women) with or without diabetes were individually linked from nationwide registers (covering both patients treated in ambulatory and in hospital inpatient care). Age-standardised rates for medication use were calculated and differences between patient groups examined using Poisson regression. RESULTS: beta-blocker use was high in all patient groups in 1997-2002, angiotensin-converting enzyme (ACE) inhibitor and angiotensin II antagonist use increased and remained higher among patients with diabetes. More than half of men and women with diabetes used ACE inhibitors and one out of five used angiotensin II antagonists in 2002. Lipid-lowering medication use increased, especially among women. In 1997-98 it was lower in lower socioeconomic groups; among men with diabetes the use remained lower than among others. CONCLUSIONS: beta-blocker use was constant and ACE inhibitor and angiotensin II antagonist use increased. Lipid-lowering medication use increased considerably after a health insurance reform in 2000, in which elevated reimbursement of drug costs (75%) was extended to include all CHD patients with hyperlipidaemia.Socioeconomic differences in medication use disappeared after the reform. However, lipid-lowering medication use remained at a lower level among men with diabetes, suggesting that their treatment did not follow guidelines.
Authors:
Tuulikki Vehko; Kristna Manderbacka; Martti Arffman; Reijo Sund; Antti Reunanen; Ilmo Keskim?ki
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-12
Journal Detail:
Title:  Scandinavian journal of public health     Volume:  38     ISSN:  1651-1905     ISO Abbreviation:  Scand J Public Health     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-03     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883503     Medline TA:  Scand J Public Health     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  317-24     Citation Subset:  IM    
Affiliation:
National Institute for Health and Welfare (THL), Helsinki, Finland. tuulikki.vehko@thl.fi
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / administration & dosage
Adult
Aged
Angiotensin II Type 1 Receptor Blockers / administration & dosage
Angiotensin-Converting Enzyme Inhibitors / administration & dosage
Antilipemic Agents / administration & dosage
Coronary Disease / diagnosis,  etiology,  prevention & control*
Diabetes Mellitus, Type 1 / complications,  drug therapy*
Diabetes Mellitus, Type 2 / complications,  drug therapy*
Drug Prescriptions / economics,  statistics & numerical data
Drug Utilization / economics,  statistics & numerical data
Female
Finland
Humans
Male
Middle Aged
Practice Guidelines as Topic
Registries
Reimbursement Mechanisms
Secondary Prevention*
Socioeconomic Factors
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antilipemic Agents

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


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