Pharmacoepidemiology – from description to quality assessment. A Swedish perspective
DOI:
https://doi.org/10.5324/nje.v11i1.531Abstract
ABSTRACT
Parallel with increasing concerns about drug safety, the importance of drug surveillance and the application
of epidemiological techniques have grown rapidly during the past decades. The increasing use of computerized
health care data facilitates the establishment of populations large enough to allow epidemiological
studies. By the use of computerized pharmacy or billing records, drug exposure is linked to files which
include outcome data (diagnoses). Pioneering pharmacoepidemiology surveys of prescriptions purchased
from defined populations were initiated in the late 1960s. Two such population-based drug databases for
research (Jämtland and Tierp) are still in use in Sweden and can provide key epidemiological data such as
incidence
and prevalence of drug use by age and sex. This basic information on drug use can only be
obtained if there is a personal identifier on the prescription. Important studies such as quality of care, polypharmacy,
drug interactions, drug abuse and physicians' prescribing habits all require data on drug use by
individuals. Unfortunately, because of sensitivity to the issue of data confidentiality in Sweden, the correspondingly
recorded data on prescriptions relative to individual patients is not available for use in health
care audits or research. With these limitations in access to patient specific data on drug use, focus is now
instead on improving the quality of drug prescribing by use of available drug statistics. The number of
drugs that account for 90% of the use – the Drug Utilization 90% segment – and adherence to guidelines in
this segment are now being tested as general indicators for assessing the quality of drug prescribing.
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