The Swedish Prescribed Drug Register and dispensed

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The Swedish Prescribed Drug Register and
dispensed

• 2009-11-04
• Andrejs Leimanis

Centre for Epidemiology - National Board of
Health and Welfare
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Drug utilization data in Sweden
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The Swedish Prescribed Drug Register

• The legislation of the Prescriptions Register
  (19961156)
• First new health data register since the Health
  Data Register Law in 1998 (1998543)
• The Swedish Prescribed Drug Register is regulated
  according to legislation SFS (2005363) issued by
  the Government

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For reasons of integrity,the Swedish Prescribed
Drug Register is only to be used for

• research
• epidemiological investigations
• production of statistics
• within the area of health and welfare

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Aspects of integrity to be regarded

• Integrity of the patientBack-way
  identification
• Integrity of the prescriberAvoid one-prescriber
  workplaces
• Integrity of the juridical person
• Business secrecy

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The Swedish Prescribed Drug Register
Hospital sales
Drug industry
Hospital records and Acquisitions in In-patient
care
Wholesaler
Pharmacy
Dispensed prescriptions

Prescriber
OTC sales
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The Swedish Prescribed Drug Register

• comprises
• All purchases of prescribed medicine at
  pharmacies (dispensed drugs) with personal
  identification number (PID)

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The Swedish Prescribed Drug Register

• exceptions
• Drugs within In-patient Care
• Drugs dispensed within, e.g. service homes,
  nursing homes
• Drugs that are used in ambulatory care but
  administered in day-care at hospitals such as
  TNF-alfa-inhibitors for the treatment of RA and
  cytotoxics
• Vaccines

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Total amount DDD and cost 2008
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of patients in the register
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Amount of substances (ATC-7)
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Drugs per person in Sweden 2008.
Men
Women
10-19
Källa Socialstyrelsens läkemedelsregister
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Prescription Information

• Personal ID-number (PID)
• missing number 0.29
• Place of residence - county, municipality, parish
• missing info 0.60

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Contents of register

• Prescribed and dispensed drugs
• Date of prescribing and dispensing
• Generic substitution
• Dosage in free text
• Volume - number of items, prescriptions DDD
• Expenditures total reimbursed

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Prescriber information

• No prescriber code !!!!
• Professiondoctors 96 , nurses 2
• Professional code - SUN-kod
• Specialist training code

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Workplace Information

• Workplace cannot be revealed !!!
• OwnershipCounty 73 , Private (contracted) 16 ,
  Private 2
• Form of carePrimary care 58 Specialist 29
• Type of careGeneral Medicine 63, Internal
  Medicine 8 ,Psychiatry 4

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Personal identification number (PID) enables

• Prevalence/incidents
• Combinations/interactions
• Polypharmacy
• Double medication
• Order of medication
• Dispensing intervals (as a measure of compliance)
• Linkage to other health registers

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National Health data registers

• Cancer register 1958-
• Medical Birth and congenital malformations
  register (1964) 1973-
• Hospital patient register 1964/1987/2001-
• Cause of death register 1952-
• Other registers

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Whats missing?

• Reason for prescription/diagnoses
• PDD
• Acquisitions in In-patient care (Ambulatory care)
• In-patient drugs
• Dispensed in service/nursing homes
• OTC
• Compliance
• No-pharmacological therapy

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