Epidemiology of multimorbidity in Iran: An investigation of a large pharmacy claims database.

Abstract:

PURPOSE:Multimorbidity (MM) (presence of more than one chronic condition within a same patient) imposes a heavy burden on patients and health care systems. In contrast to high-income countries, the epidemiology of this phenomenon is unclear in low- and middle-income countries, particularly among Iranian population. METHODS:This was a retrospective cohort study using Iranian Health Insurance Organization claims database. A framework was developed for identifying a set of 18 chronic conditions from the pharmacy claims data in Iran. All 2013 outpatient utilizers (aged 18 years or older) were included. Data were analyzed according to number of chronic conditions, gender, and age. The association between MM and utilizations of health services was examined for 2013 to 2016. RESULTS:In total, 481 733 people were included. Cardiovascular diseases (including hypertension) (19.1%), depression/anxiety/sleep disorders (13.7%), and acid-related disorders (10.3%) were the three most prevalent conditions. MM was present in 21.1%. Although prevalence of MM is higher in older age groups and was present in 40% of individuals aged 65 and older, the absolute number of multimorbid patients was higher in those younger than 65 years (66 271 vs 35 386). MM was more prevalent among women (22.1%) compared with men (19.5). After multivariate adjustment for age group and sex, each additional chronic condition was associated with an increase of 2.23 physician visits, 2.86 drugs dispensed, 2.32 laboratory tests, and 1.6 medical imaging. CONCLUSIONS:Our findings challenge the current single-disease-based assumption implicit in Iranian health care system. To take account of MM, complementary strategies should be designed and implement in health care system.

authors

Ebrahimoghli R,Janati A,Sadeghi-Bazargani H,Hamishehkar H,Ghaffari S,Sanaat Z,Farahbakhsh M,Farhoudi M,Khalili-Azimi A

doi

10.1002/pds.4925

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

39-47

issue

1

eissn

1053-8569

issn

1099-1557

journal_volume

29

pub_type

杂志文章
  • Doctor hopping and doctor shopping for prescription opioids associated with increased odds of high-risk use.

    abstract:PURPOSE:Early detection of risky behaviors involving prescription opioids can assist prescribers in implementing safer prescribing. Patient-to-prescriber travel patterns may indicate potential opioid misuse. We introduce doctor hopping, patients bypassing nearby prescribers in favor of more distant ones, as a new spati...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.4838

    authors: Young SG,Hayes CJ,Aram J,Tait MA

    更新日期:2019-08-01 00:00:00

  • Adherence to osteoporosis pharmacotherapy is underestimated using days supply values in electronic pharmacy claims data.

    abstract:PURPOSE:Days supply (prescription duration) values are commonly used to estimate drug exposure and quantify adherence to therapy, yet accuracy is not routinely assessed, and potential inaccurate reporting has been previously identified. We examined the impact of cleaning days supply values on the measurement of adheren...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.3718

    authors: Burden AM,Paterson JM,Gruneir A,Cadarette SM

    更新日期:2015-01-01 00:00:00

  • Results from a 9-year Intensive Safety Surveillance Scheme (IS(3) ) in miglustat (Zavesca(®) )-treated patients.

    abstract:BACKGROUND:Following approval in the EU in 2002 and the USA in 2003, an Intensive Safety Surveillance Scheme (IS(3) ) was initiated to educate prescribers on the appropriate use of miglustat for the treatment of type I Gaucher disease (GD1), and to actively solicit safety-relevant information. This report summarises da...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章,多中心研究

    doi:10.1002/pds.3760

    authors: Brand M,Muller A,Alsop J,van Schaik IN,Bembi B,Hughes D

    更新日期:2015-03-01 00:00:00

  • Cardiac mortality in users of olmesartan, other angiotensin-receptor blockers and angiotensin-converting enzyme inhibitors.

    abstract:PURPOSE:Clinical trials of olmesartan for prevention of progression of renal disease in patients with diabetes showed renal protection but an unexpected imbalance in cardiac deaths. The US Food and Drug Administration requested from the manufacturer a cohort study of olmesartan, other angiotensin-receptor blockers (ARB...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.3558

    authors: Walker AM,Liang C,Clifford CR,Parker C,Feldman A

    更新日期:2014-04-01 00:00:00

  • Bayesian hierarchical methods in the detection of potentially teratogenic first-trimester medications.

    abstract:PURPOSE:Bayesian hierarchical models (BHMs) have been used to identify adverse drug reactions, allowing information sharing amongst adverse reactions and drugs expected to have similar properties. This study evaluated the use of BHMs in the routine signal detection analyses of potential first-trimester teratogens, wher...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.4948

    authors: Cavadino A,Prieto-Merino D,Morris JK

    更新日期:2020-03-01 00:00:00

  • Effectiveness of rosuvastatin compared to other statins for the prevention of cardiovascular events-a cohort study in 395 039 patients from clinical practice.

    abstract:PURPOSE:This study compared the effectiveness of rosuvastatin (RSV) to other statins prescribed in clinical practice in prevention of cardiovascular (CV) events. METHODS:This longitudinal inception cohort study, using Thomson Healthcare's MarketScan databases, included patients aged > or = 18 starting statin therapy d...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.1843

    authors: Motsko SP,Russmann S,Ming EE,Singh VP,Vendiola RM,Jones JK

    更新日期:2009-12-01 00:00:00

  • Use of granulocyte colony-stimulating factor (G-CSF) and outcome in patients with non-chemotherapy agranulocytosis.

    abstract:PURPOSE:The use of granulocyte colony-stimulating factor (G-CSF) in the treatment of non-chemotherapy drug- induced agranulocytosis is controversial. We aimed at assessing the effect of G-CSF on the duration of agranulocytosis. METHODS:To assess the effect of G-CSF on the duration of agranulocytosis, a Cox proportiona...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.1542

    authors: Ibáñez L,Sabaté M,Ballarín E,Puig R,Vidal X,Laporte JR,Agranulocytosis and Aplastic Anaemia Study Group of Barcelona.

    更新日期:2008-03-01 00:00:00

  • Inter-practice variation in polypharmacy prevalence amongst older patients in primary care.

    abstract:PURPOSE:Complex medication management in older people with multiple chronic conditions can introduce practice variation in polypharmacy prevalence. This study aimed to determine the inter-practice variation in polypharmacy prevalence and examine how this variation was influenced by patient and practice characteristics....

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.4016

    authors: Sinnige J,Braspenning JC,Schellevis FG,Hek K,Stirbu I,Westert GP,Korevaar JC

    更新日期:2016-09-01 00:00:00

  • Safety of deferasirox: a retrospective cohort study on the risks of gastrointestinal, liver and renal events.

    abstract:BACKGROUND:Deferasirox (DFX) is an effective and well-tolerated oral iron chelator elevating the adherence to iron chelating therapy among patients with iron overload. However, the US Food and Drug Administration issued a warning about the potential adverse events associated with DFX in 2010. METHODS:To examine the ri...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.3657

    authors: Huang WF,Chou HC,Tsai YW,Hsiao FY

    更新日期:2014-11-01 00:00:00

  • Potentially inappropriate prescribing to hospitalised patients.

    abstract:PURPOSE:The objective of this study was to evaluate the prevalence of potential drug-drug interactions (DDIs) in hospitalised patients in correlation with patient's age and number of drugs prescribed and to determine the prevalence of inappropriate drugs prescribed to elderly patients. METHODS:Drugs prescribed during ...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.1531

    authors: Radosević N,Gantumur M,Vlahović-Palcevski V

    更新日期:2008-07-01 00:00:00

  • Modeling exposures of medications used episodically during pregnancy: Triptans as a motivating example.

    abstract:PURPOSE:To assess the validity of dispensed prescription to classify exposure to medications used episodically during pregnancy, and to explore individual trajectories of episodic medication use across pregnancy, using triptans for migraine as the motivating example. METHODS:We compared self-reported triptan use durin...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.5089

    authors: Harris GE,Wood M,Nordeng H

    更新日期:2020-09-01 00:00:00

  • Weaknesses of goodness-of-fit tests for evaluating propensity score models: the case of the omitted confounder.

    abstract:PURPOSE:Propensity scores are used in observational studies to adjust for confounding, although they do not provide control for confounders omitted from the propensity score model. We sought to determine if tests used to evaluate logistic model fit and discrimination would be helpful in detecting the omission of an imp...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.986

    authors: Weitzen S,Lapane KL,Toledano AY,Hume AL,Mor V

    更新日期:2005-04-01 00:00:00

  • Herbal products use during pregnancy: prevalence and predictors.

    abstract:PURPOSES:(1) Measure the prevalence of herbal product (HP) use, alone, and concomitantly with prescribed medications during pregnancy, (2) identify the most frequently consumed HP during gestation and (3) determine predictors of HP use at the beginning of pregnancy, and during the third trimester. METHODS:A questionna...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章,评审

    doi:10.1002/pds.1731

    authors: Moussally K,Oraichi D,Bérard A

    更新日期:2009-06-01 00:00:00

  • Statins in the prevention of dementia and Alzheimer's disease: a meta-analysis of observational studies and an assessment of confounding.

    abstract:BACKGROUND:Studies demonstrate the potential for statins to prevent dementia and Alzheimer's disease (AD), but the evidence is inconclusive. OBJECTIVE:Conduct a meta-analysis to estimate any benefit of statins in preventing dementia and examine the potential effect of study design and confounding on the benefit of sta...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章,meta分析

    doi:10.1002/pds.3381

    authors: Wong WB,Lin VW,Boudreau D,Devine EB

    更新日期:2013-04-01 00:00:00

  • Assessment of colistimethate sodium (COLOBREATHE) risk minimization measures implemented in the European Union: A cross-sectional study.

    abstract:PURPOSE:To assess the effectiveness of additional risk minimization measures (aRMMs) implemented in Europe for colistimethate sodium (CMS) among healthcare professionals (HCPs) and patients/caregivers following safety concerns regarding incorrect use of CMS delivered via Turbospin inhaler. METHODS:A cross-sectional st...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.4940

    authors: Kaplan S,Patino O,Rainville C,Madison T

    更新日期:2020-02-01 00:00:00

  • Domperidone, cytochrome P450 3A4 isoenzyme inhibitors and ventricular arrhythmia: a nationwide case-crossover study.

    abstract:BACKGROUND:Recent evidence suggested that oral form of domperidone may possess pro-arrhythmic effects and increase the risk of ventricular arrhythmia. The concomitant use of cytochrome P450 (CYP) 3A4 isoenzyme inhibitors may further potentiate this association. Nevertheless, empirical data supporting these associations...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.3814

    authors: Chen HL,Hsiao FY

    更新日期:2015-08-01 00:00:00

  • Population-based incidence of diabetic ketoacidosis in type 2 diabetes: medical claims data analysis in Japan.

    abstract:PURPOSE:Determination of the incidence rate of diabetic ketoacidosis (DKA) in type 2 diabetes mellitus (T2DM) is urgent, in response to the safety issue with use of the glucose lowering drugs, sodium-glucose cotransporter-2 inhibitors, and DKA. METHODS:We extracted data of adult patients with T2DM from a medical claim...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.4271

    authors: Takeuchi M,Kawamura T,Sato I,Kawakami K

    更新日期:2018-01-01 00:00:00

  • Impact of antibiotic exposure on the risk of colorectal cancer.

    abstract:PURPOSE:Gut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue. Our aim was to evaluate the association between the type and cumulative duration of antibiotic exposure and CRC risk. METHODS:We conducted a nested case-control s...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.3765

    authors: Boursi B,Haynes K,Mamtani R,Yang YX

    更新日期:2015-05-01 00:00:00

  • Antidepressant medication use and breast cancer risk.

    abstract:PURPOSE:Most epidemiologic studies have detected no association between prior use of antidepressant medications and breast cancer risk. Despite the uniform conclusion, there is a continuous rise in the proportion of women using antidepressants, lending support to further monitoring of disease effects. METHODS:We condu...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.1719

    authors: Wernli KJ,Hampton JM,Trentham-Dietz A,Newcomb PA

    更新日期:2009-04-01 00:00:00

  • Risk factors associated with preterm birth according to gestational age at birth.

    abstract:PURPOSE:To identify and quantify risk factors associated with preterm birth, stratified by gestational age at birth. METHODS:Three case-control analyses were done. Controls were pregnancies of > or =37 weeks of gestational age at birth. Cases were defined as: <28, 28-32, 33- <37 weeks of gestational age at birth respe...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.1575

    authors: Ofori BD,Le Tiec M,Bérard A

    更新日期:2008-06-01 00:00:00

  • The state of dietary supplement adverse event reporting in the United States.

    abstract:PURPOSE:The Dietary Supplements Information Expert Committee (DSI-EC; the Committee) of the United States Pharmacopeial Convention (USP) reviews safety profiles of dietary supplements before development of USP-National Formulary (USP-NF) quality monographs. Because the veracity of dietary supplement adverse event repor...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章,评审

    doi:10.1002/pds.1627

    authors: Gardiner P,Sarma DN,Low Dog T,Barrett ML,Chavez ML,Ko R,Mahady GB,Marles RJ,Pellicore LS,Giancaspro GI

    更新日期:2008-10-01 00:00:00

  • Validity and completeness of colorectal cancer diagnoses in a primary care database in the United Kingdom.

    abstract:PURPOSE:To validate the recorded diagnoses of colorectal cancer (CRC) and identify false negatives in The Health Improvement Network (THIN) primary care database. METHODS:We conducted a validation study of incident CRC cases in THIN among patients aged 40-89 years from 2000-2011. CRC Read code entries (N = 3805) were ...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.3877

    authors: Cea Soriano L,Soriano-Gabarró M,García Rodríguez LA

    更新日期:2016-04-01 00:00:00

  • Algorithms to estimate the beginning of pregnancy in administrative databases.

    abstract:PURPOSE:The role of administrative databases for research on drug safety during pregnancy can be limited by their inaccurate assessment of the timing of exposure, as the gestational age at birth is typically unavailable. Therefore, we sought to develop and validate algorithms to estimate the gestational age at birth us...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.3284

    authors: Margulis AV,Setoguchi S,Mittleman MA,Glynn RJ,Dormuth CR,Hernández-Díaz S

    更新日期:2013-01-01 00:00:00

  • Statin and NSAID use and prostate cancer risk.

    abstract:PURPOSE:Some studies have reported reduced risks of advanced, but not early, prostate cancer among statin users, and one study found a reduced risk only among statin users who had also used non-steroidal anti-inflammatory drugs (NSAIDs). We have previously reported no association between statin use and prostate cancer ...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.1970

    authors: Coogan PF,Kelly JP,Strom BL,Rosenberg L

    更新日期:2010-07-01 00:00:00

  • Assessing strength of evidence for regulatory decision making in licensing: What proof do we need for observational studies of effectiveness?

    abstract::Before a medicine can be recommended for a marketing authorization research must be provided to regulators that convincingly supports the benefit-risk of the product in the claimed indication. The established criteria for such research are usually expressed in terms of evidence from randomized controlled trials (RCT)....

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.5005

    authors: Slattery J,Kurz X

    更新日期:2020-10-01 00:00:00

  • Use of a multi-state model in a claims database: illustration with methadone.

    abstract:PURPOSE:In pharmacoepidemiology, one of the main concerns is analysis of drug exposure time. However, in real-life settings, patient's behavior is complex and characterized by drug exposure dynamics. Multi-state models allow assessing the probabilities of various patterns, instead of just continuous use and/or disconti...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.3835

    authors: Boucherie Q,Pauly V,Frauger E,Thirion X,Pradel V,Micallef J

    更新日期:2015-09-01 00:00:00

  • Systematic review of cross-national drug utilization studies in Latin America: methods and comparability.

    abstract:PURPOSE:We systematically review the cross-national drug utilization studies performed in Latin America (LA) in order to analyze the methods applied and assess the validity of the data to ensure the comparability. METHODS:A systematic search in Medline, Embase, and BIREME was performed. Drug utilization studies includ...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章,评审

    doi:10.1002/pds.3896

    authors: Durán CE,Christiaens T,Acosta Á,Vander Stichele R

    更新日期:2016-01-01 00:00:00

  • Systemic conditions for performance of pharmacoepidemiologic studies in Slovenia.

    abstract::In Slovenia, the national health insurance system covers almost the whole population. The average patient receives six to seven prescriptions per year with an average value of 15 USD per prescription. This paper presents the systemic conditions necessary for the performance of pharmacoepidemiologic studies. A recent s...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.646

    authors: Primozic S,Kos M,Mrhar A,Ravnik I

    更新日期:2001-12-01 00:00:00

  • Language competence and communication skills in 3-year-old children after prenatal exposure to analgesic opioids.

    abstract:PURPOSE:An increasing consumption of opioids in the general population has been reported in several countries also among pregnant women. Limited information is available regarding the effect of prenatal exposure to analgesic opioids on long-term neurocognitive function in children. The primary aim of the study was to d...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.4170

    authors: Skovlund E,Handal M,Selmer R,Brandlistuen RE,Skurtveit S

    更新日期:2017-06-01 00:00:00

  • Validation of low-dose aspirin prescription data in The Health Improvement Network: how much misclassification due to over-the-counter use?

    abstract:PURPOSE:We aimed to quantify the extent of over-the-counter (OTC) low-dose aspirin use among patients in The Health Improvement Network (THIN) in the UK. METHODS:In September 2013, a random sample of low-dose aspirin users (75 past users and 75 never users) was identified based on prescriptions recorded in THIN. Prima...

    journal_title:Pharmacoepidemiology and drug safety

    pub_type: 杂志文章

    doi:10.1002/pds.3926

    authors: Cea Soriano L,Soriano-Gabarró M,García Rodríguez LA

    更新日期:2016-04-01 00:00:00