Coordinator research program Care Demand of the Chronically Ill and Disabled; honorary professor 'Pharmacy health services research', University of Groningen, the Netherlands
Publicatie
The use of GP databases in comparative research: the case of diabetes care in Sweden and the Netherlands.
Dijk, L. van, Lindblad, U., Melander, A., Verheij, R. The use of GP databases in comparative research: the case of diabetes care in Sweden and the Netherlands. Pharmacoepidemiology and Drug Safety: 2008, 17(suppl. 1), p. 75-76. Abstract. 24th International Conference on Pharmacoepidemiology & Therapeutic Risk Management, Kopenhagen, 18 augustus 2008.
Background
The prevalence of diabetes mellitus (DM) is increasing globally. In many European countries, management of DM has become a responsibility of primary care.
Objectives
To compare pharmaceutical treatment of DM in Sweden and the Netherlands for patients with and without cardiovascular co-morbidity using routine primary care registration databases.
Methods
Data (2005) were used from the Skaraborg Primary Care Reasearch Database (SPCRD) and the Netherlands Information Network of General Practice (LINH) Setting: general practices/health care centers, subjects: 19,000 patients with diabetes mellitus Main outcome measure: pharmaceutical treatment of patients with diabetes (yes/no) Analysis: Multilevel analysis from which the percentage of patients in each country twith certain treatment was calculated.
Results
Overall, pharmaceutical treatment of diabetes patients with antihyperglycmic drugs and statins is more likely in the Netherlands compared to Sweden, but insulin is a more preferred treatment in Sweden (25% in Sweden versus 16% in the Netherlands) Higher treatment rates in the Netherlands are fully attributable to patients without cardiovascular co-morbidity. Dutch DM patients without cardiovascular co-morbidity receive the same pharmaceutical treatment as their counterparts with cardiovascular co-morbidity. Swedish GPs, however, make a clear distinction
between DM patients with and without cardiovascular comorbidity. A striking difference between the two countries is that while in the Netherlands 40% of all DM patients without cardiovascular co-morbidity were prescribed statins, none of their Swedish peers was.
Conclusions
Our study (re-) emphasizes that there are considerable between-country differences in the management of DM and that cardiovascular co-moborbidity cannot be ignored in the explanation of cross-country variation in pharmaceutical treatment of DM.
The prevalence of diabetes mellitus (DM) is increasing globally. In many European countries, management of DM has become a responsibility of primary care.
Objectives
To compare pharmaceutical treatment of DM in Sweden and the Netherlands for patients with and without cardiovascular co-morbidity using routine primary care registration databases.
Methods
Data (2005) were used from the Skaraborg Primary Care Reasearch Database (SPCRD) and the Netherlands Information Network of General Practice (LINH) Setting: general practices/health care centers, subjects: 19,000 patients with diabetes mellitus Main outcome measure: pharmaceutical treatment of patients with diabetes (yes/no) Analysis: Multilevel analysis from which the percentage of patients in each country twith certain treatment was calculated.
Results
Overall, pharmaceutical treatment of diabetes patients with antihyperglycmic drugs and statins is more likely in the Netherlands compared to Sweden, but insulin is a more preferred treatment in Sweden (25% in Sweden versus 16% in the Netherlands) Higher treatment rates in the Netherlands are fully attributable to patients without cardiovascular co-morbidity. Dutch DM patients without cardiovascular co-morbidity receive the same pharmaceutical treatment as their counterparts with cardiovascular co-morbidity. Swedish GPs, however, make a clear distinction
between DM patients with and without cardiovascular comorbidity. A striking difference between the two countries is that while in the Netherlands 40% of all DM patients without cardiovascular co-morbidity were prescribed statins, none of their Swedish peers was.
Conclusions
Our study (re-) emphasizes that there are considerable between-country differences in the management of DM and that cardiovascular co-moborbidity cannot be ignored in the explanation of cross-country variation in pharmaceutical treatment of DM.
Background
The prevalence of diabetes mellitus (DM) is increasing globally. In many European countries, management of DM has become a responsibility of primary care.
Objectives
To compare pharmaceutical treatment of DM in Sweden and the Netherlands for patients with and without cardiovascular co-morbidity using routine primary care registration databases.
Methods
Data (2005) were used from the Skaraborg Primary Care Reasearch Database (SPCRD) and the Netherlands Information Network of General Practice (LINH) Setting: general practices/health care centers, subjects: 19,000 patients with diabetes mellitus Main outcome measure: pharmaceutical treatment of patients with diabetes (yes/no) Analysis: Multilevel analysis from which the percentage of patients in each country twith certain treatment was calculated.
Results
Overall, pharmaceutical treatment of diabetes patients with antihyperglycmic drugs and statins is more likely in the Netherlands compared to Sweden, but insulin is a more preferred treatment in Sweden (25% in Sweden versus 16% in the Netherlands) Higher treatment rates in the Netherlands are fully attributable to patients without cardiovascular co-morbidity. Dutch DM patients without cardiovascular co-morbidity receive the same pharmaceutical treatment as their counterparts with cardiovascular co-morbidity. Swedish GPs, however, make a clear distinction
between DM patients with and without cardiovascular comorbidity. A striking difference between the two countries is that while in the Netherlands 40% of all DM patients without cardiovascular co-morbidity were prescribed statins, none of their Swedish peers was.
Conclusions
Our study (re-) emphasizes that there are considerable between-country differences in the management of DM and that cardiovascular co-moborbidity cannot be ignored in the explanation of cross-country variation in pharmaceutical treatment of DM.
The prevalence of diabetes mellitus (DM) is increasing globally. In many European countries, management of DM has become a responsibility of primary care.
Objectives
To compare pharmaceutical treatment of DM in Sweden and the Netherlands for patients with and without cardiovascular co-morbidity using routine primary care registration databases.
Methods
Data (2005) were used from the Skaraborg Primary Care Reasearch Database (SPCRD) and the Netherlands Information Network of General Practice (LINH) Setting: general practices/health care centers, subjects: 19,000 patients with diabetes mellitus Main outcome measure: pharmaceutical treatment of patients with diabetes (yes/no) Analysis: Multilevel analysis from which the percentage of patients in each country twith certain treatment was calculated.
Results
Overall, pharmaceutical treatment of diabetes patients with antihyperglycmic drugs and statins is more likely in the Netherlands compared to Sweden, but insulin is a more preferred treatment in Sweden (25% in Sweden versus 16% in the Netherlands) Higher treatment rates in the Netherlands are fully attributable to patients without cardiovascular co-morbidity. Dutch DM patients without cardiovascular co-morbidity receive the same pharmaceutical treatment as their counterparts with cardiovascular co-morbidity. Swedish GPs, however, make a clear distinction
between DM patients with and without cardiovascular comorbidity. A striking difference between the two countries is that while in the Netherlands 40% of all DM patients without cardiovascular co-morbidity were prescribed statins, none of their Swedish peers was.
Conclusions
Our study (re-) emphasizes that there are considerable between-country differences in the management of DM and that cardiovascular co-moborbidity cannot be ignored in the explanation of cross-country variation in pharmaceutical treatment of DM.
