Dataset Information

Co-prescription patterns of cardiovascular preventive treatments: a cross-sectional study in the Aragon worker' health study (Spain).

ABSTRACT:

Objectives

To identify cardiovascular disease (CVD) preventive treatments combinations, among them and with other drugs, and to determine their prevalence in a cohort of Spanish workers.

Design

Cross-sectional study.

Setting

Aragon Workers' Health Study (AWHS) cohort in Spain.

Participants

5577 workers belonging to AWHS cohort. From these subjects, we selected those that had, at least, three prescriptions of the same therapeutic subgroup in 2014 (n=4605).

Primary and secondary outcome measures

Drug consumption was obtained from the Aragon Pharmaceutical Consumption Registry (Farmasalud). In order to know treatment utilisation, prevalence analyses were conducted. Frequent item set mining techniques were applied to identify drugs co-prescription patterns. All the results were stratified by sex and age.

Results

42.3% of men and 18.8% of women in the cohort received, at least, three prescriptions of a CVD preventive treatment in 2014. The most prescribed CVD treatment were antihypertensives (men: 28.2%, women 9.2%). The most frequent association observed among CVD preventive treatment was agents acting on the renin-angiotensin system and lipid-lowering drugs (5.1% of treated subjects). Co-prescription increased with age, especially after 50 years old, both in frequency and number of associations, and was higher in men. Regarding the association between CVD preventive treatments and other drugs, the most frequent pattern observed was lipid-lowering drugs and drugs used for acid related disorders (4.2% of treated subjects).

Conclusions

There is an important number of co-prescription patterns that involve CVD preventive treatments. These patterns increase with age and are more frequent in men. Mining techniques are a useful tool to identify pharmacological patterns that are not evident in the individual clinical practice, in order to improve drug prescription appropriateness.

SUBMITTER: Aguilar-Palacio I

PROVIDER: S-EPMC6500350 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Co-prescription patterns of cardiovascular preventive treatments: a cross-sectional study in the Aragon worker' health study (Spain).

Aguilar-Palacio Isabel I Malo Sara S Lallana MªJesús M Feja Cristina C González Juan J Moreno-Franco Belén B Rabanaque MªJosé M

BMJ open 20190414 4

<h4>Objectives</h4>To identify cardiovascular disease (CVD) preventive treatments combinations, among them and with other drugs, and to determine their prevalence in a cohort of Spanish workers.<h4>Design</h4>Cross-sectional study.<h4>Setting</h4>Aragon Workers' Health Study (AWHS) cohort in Spain.<h4>Participants</h4>5577 workers belonging to AWHS cohort. From these subjects, we selected those that had, at least, three prescriptions of the same therapeutic subgroup in 2014 (n=4605).<h4>Primary ...[more]

PMID: 30987984

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Project description:ObjectivesSystematic review of preventive pharmacologic treatments for community-dwelling adults with episodic migraine.Data sourcesElectronic databases through May 20, 2012.Eligibility criteriaEnglish-language randomized controlled trials (RCTs) of preventive drugs compared to placebo or active treatments examining rates of ?50 % reduction in monthly migraine frequency or improvement in quality of life.Study appraisal and synthesis methodsWe assessed risk of bias and strength of evidence and conducted random effects meta-analyses of absolute risk differences and Bayesian network meta-analysis.ResultsOf 5,244 retrieved references, 215 publications of RCTs provided mostly low-strength evidence because of the risk of bias and imprecision. RCTs examined 59 drugs from 14 drug classes. All approved drugs, including topiramate (9 RCTs), divalproex (3 RCTs), timolol (3 RCTs), and propranolol (4 RCTs); off-label beta blockers metoprolol (4 RCTs), atenolol (1 RCT), nadolol (1 RCT), and acebutolol (1 RCT); angiotensin-converting enzyme inhibitors captopril (1 RCT) and lisinopril (1 RCT); and angiotensin II receptor blocker candesartan (1 RCT), outperformed placebo in reducing monthly migraine frequency by ?50 % in 200-400 patients per 1,000 treated. Adverse effects leading to treatment discontinuation (68 RCTs) were greater with topiramate, off-label antiepileptics, and antidepressants than with placebo. Limited direct evidence as well as frequentist and exploratory network Bayesian meta-analysis showed no statistically significant differences in benefits between approved drugs. Off-label angiotensin-inhibiting drugs and beta-blockers were most effective and tolerable for episodic migraine prevention.LimitationsWe did not quantify reporting bias or contact principal investigators regarding unpublished trials.ConclusionsApproved drugs prevented episodic migraine frequency by ?50 % with no statistically significant difference between them. Exploratory network meta-analysis suggested that off-label angiotensin-inhibiting drugs and beta-blockers had favorable benefit-to-harm ratios. Evidence is lacking for long-term effects of drug treatments (i.e., trials of more than 3 months duration), especially for quality of life.

Dataset Information

Co-prescription patterns of cardiovascular preventive treatments: a cross-sectional study in the Aragon worker' health study (Spain).

Objectives

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Co-prescription patterns of cardiovascular preventive treatments: a cross-sectional study in the Aragon worker' health study (Spain).

Similar Datasets

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