Second Dutch National Survey (second + dutch_national_survey)

Distribution by Scientific Domains

Selected Abstracts

An algorithm to identify antidepressant users with a diagnosis of depression from prescription data

Helga Gardarsdottir PharmD
Abstract Purpose Antidepressants are used for many indications besides depression. This makes investigating depression treatment outcomes in prescription databases problematic when the indication is unknown. The aim of our study is to develop an algorithm to identify antidepressant drug users from prescription data that suffer from depression. Methods Data for deriving the algorithm were obtained from the Second Dutch National Survey of General Practice, carried out in 2001 by The Netherlands Institute for Health Services Research (NIVEL), and for validation the Integrated Primary Care Information (IPCI) database was used. Both sets included adults receiving their first antidepressant drug in 2001 (n,=,1855 and 3321, respectively). The outcome was a registered diagnosis of depression. Covariates investigated for developing the algorithm were patient and prescribing characteristics, and co-medication. Results The predictive algorithm included age, SSRI prescribed on the index date, prescribed dose, general practitioner as prescriber and the number of antidepressant prescriptions prescribed plus medication for treating acid related disorders, laxatives, cardiac therapy or hypnotics/sedatives prescribed in the 6 months prior to index date. The probability that the algorithm correctly identified an antidepressant drug user as having a depression diagnosis was 79% with a sensitivity of 79.6% and a specificity of 66.9%. Conclusion In conclusion, we developed and validated an algorithm that can be used to compose cohorts of patients treated with antidepressants for depression from prescription databases. Copyright 2008 John Wiley & Sons, Ltd. [source]

Antibiotics in Dutch general practice: nationwide electronic GP database and national reimbursement rates,

Annemiek E. Akkerman PhD
Abstract Purpose In order to assess whether different databases generate information which can be reliable compared with each other, this study aimed to assess to which degree prescribing rates for systemic antibiotics from a nationwide electronic general practitioner (GP) database correspond with national reimbursement rates, and to investigate for which indications antibiotics are prescribed. Methods Nationwide GP prescribing data were collected from the Second Dutch National Survey of General Practice (DNSGP-2) based on 90 general practices serving 358 008 patients in 2001. Dutch national reimbursement rates for GPs were derived from claims data of the Dutch Drug Information System/Health Care Insurance Board (GIP/CVZ) from 2001. We calculated antibiotic prescribing rates per 1000 patients/inhabitants for each database, and these rates were compared for the total rates and according to antibiotic subgroups. Indications for which GPs prescribed antibiotics were described. Results In national reimbursement data, 339 antibiotic prescriptions per 1000 inhabitants were prescribed by GPs, while the nationwide GP database showed 255 prescriptions per 1000 patients (75% coverage with reimbursement rates). The nationwide GP database showed high volumes of sulphonamides & trimethoprim, and small volumes of macrolides and quinolones. Half of the prescriptions (48%) were prescribed for respiratory diseases, a quarter (26%) for urinary diseases and 7% for ear diseases. Conclusions GPs voluntarily participating in a research network prescribe less antibiotics than Dutch GPs in general, and are cautious in prescribing newer and more broad-spectrum antibiotics. This point has to be taken into account when databases will be compared with each other. Copyright 2007 John Wiley & Sons, Ltd. [source]

Morbidity and Health-Care Use in People with Intellectual Disabilities in General Practice: First Results of a Survey in the Netherlands

H. M. J Van Schrojenstein Lantman-de Valk
Abstract, Reported here are the preliminary results of the second Dutch National Survey of General Practice in which data were collected on all contacts with general practitioners (GPs) during a 12-month period to determine characteristics of patients with intellectual disabilities (ID). Sociodemographic characteristics differed significantly between people with ID and controls, indicating significant differences in morbidity between the two groups (people with ID were found to have more psychological problems, more digestive problems, more ear problems, more neurological problems, and more general and unspecified problems). [source]

The trade-off between cardiovascular and gastrointestinal effects of rofecoxib,

Stefan R. Florentinus PharmD
Abstract An Erratum has been published for this article in Pharmacoepidemiology and Drug Safety 14(9), 2005, 669. Background The cyclooxygenase-2 (COX-2) inhibitor rofecoxib was registered in 1999. By 2000, the first reports were published indicating that the agent was possibly associated with an increased risk of myocardial infarction. Since then a surge of data supporting this association has become available. To interpret these data it is essential to ascertain the cardiovascular risk profile of users of rofecoxib relative to other non-steroidal anti-inflammatory drug (NSAID) recipients. Objective To assess differences in cardiovascular risk between starters of rofecoxib versus starters of any other NSAID. Setting Data sampled from a representative research network of Dutch general practitioners (GPs) in 2001. Design New users (starters) of rofecoxib were compared to starters of any other NSAID, unmatched and matched on age, gender, and indication nested in the cohort of the second Dutch National Survey of General Practice. Results A total of 40.4% of patients starting on rofecoxib had cardiovascular co-morbidity. Patients starting on rofecoxib were twice more likely to have a history of gastrointestinal (GI) morbidity, compared to patients starting on other NSAIDs (ORadj,=,2.09; 95%CI,=,1.65,2.66). These patients were also more likely to have cardiovascular co-morbidity (OR,=,1.90; 95%CI,=,1.60,2.24) compared to recipients of rofecoxib with no GI co-morbidity. Cardiovascular morbidity was present at the time of rofecoxib exposure in over 61% of carriers of a composite risk profile including age 60 years or older, GI co-morbidity and diagnosis of rheumatoid arthritis and osteoarthritis. Conclusions In general, a typical recipient of an NSAID is aged and carrier of a serious cardiovascular risk profile. Selective prescribing of rofecoxib to provide claimed gastroprotection, indirectly and unintentionally resulted in prescribing rofecoxib in a population with high frequencies of cardiovascular morbidities. Copyright 2005 John Wiley & Sons, Ltd. [source]