Abstract:
Assessing the disease burden of diabetes in general populations is important for planning and monitoring public health initiatives. Prevalence is the relative frequency of diseased subjects in a population, and is the default measure of disease burden. Traditional epidemiological methods for estimating prevalence are however costly, and so it has been suggested to exploit the advent of large scale pharmacoepidemiological databases for estimating diabetes prevalence, as these databases are available at nominal costs. In this paper we review how information on either gross volume sales of anti-diabetic agents or on prescription redemptions have been used to estimate the prevalence of diabetes, as well as incidence and mortality among treated. For studies based on gross volume sales, the critical prerequisite is to obtain valid estimates of average drug consumption among treated diabetics. Studies based on individual level information on prescription redemptions requires determination of treatment status, either explicitly via decision rules or implicitly via a stochastic model. For the latter, the Waiting Time Distribution has been suggested. While prevalence estimates based on pharmacoepidemiologic databases are found to underestimate overall prevalence of diabetes – by definition, they only concern diabetics treated pharmacologically – good agreement is found with respect to trend estimates of both prevalence, incidence, and mortality among diabetics. Pharmacoepidemiologic databases can therefore be a valuable source of data for cost-effective monitoring of developments in the disease burden of diabetes.
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Abbreviations
- ATC:
-
anatomic-therapeutic-chemical
- CDD:
-
consumed daily doses
- DDD:
-
defined daily doses
- NHANES:
-
national health and nutrition examination survey
- PDD:
-
prescribed daily doses
- UKPDS:
-
United Kingdom prospective diabetes study
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Appendix
Appendix
Key Facts of Pharmacoepidemiology
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Pharmacoepidemiology measures drug utilization in general populations and its effects.
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Pharmacoepidemiologic databases collects information on dispensed medications within a defined region and time period.
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Pharmaceutical drugs are classified according to their targeted anatomical system, intended therapeutic effect, and chemical composition in the ATC system.
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Electronic pharmacoepidemiologic databases with individual level information covering entire populations have been established in Scandinavian countries since 1990.
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Støvring, H. (2010). The Use of Pharmacoepidemiological Databases to Assess Disease Burdens: Application to Diabetes. In: Preedy, V.R., Watson, R.R. (eds) Handbook of Disease Burdens and Quality of Life Measures. Springer, New York, NY. https://doi.org/10.1007/978-0-387-78665-0_39
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DOI: https://doi.org/10.1007/978-0-387-78665-0_39
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