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Title of Journal: Eur J Clin Pharmacol

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Abbravation: European Journal of Clinical Pharmacology

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Springer-Verlag

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DOI

10.1007/bf02477912

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1432-1041

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Early discontinuation more frequent among general

Authors: Dorte Gilså Hansen Anthony Gichangi Werner Vach Lina Hoel Felde John Larsen
Publish Date: 2007/07/06
Volume: 63, Issue: 9, Pages: 861-865
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Abstract

Introduction Discontinuation of medical drug treatment is a serious problem in primary care The need for a better understanding of the processes including physicianspecific mechanisms is apparent The aim of this study was to analyse the association between general practitioners’ prescribing prevalence and rate of early discontinuation of different drugs consisting of in this study lipidlowering drugs antihypertensive drugs antidepressants antidiabetics and drugs against osteoporosisMaterial and methods This was a register study based on prescription data covering a 4year period and consisting of 470000 citizens For each practice and group of drug a 1year prevalence for 2002 and the rate of early discontinuation among new users in 2002–2003 were estimated Early discontinuation was defined as no prescriptions during the second halfyear following the first prescription with the exception of new users of antidepressants for whom it was the first halfyear Correlations were analysed using the SAS ver 91PROC MIXED procedure The association with the total prescribing prevalence all drugs was also analysedResults A total of 141 general practices were included in the study There was a positive association between the prevalence of prescribing for the specific drugs studied antidepressants antidiabetics drugs against osteoporosis and lipidlowering drugs and early discontinuation r = 029 –044 but not for antihypertensive drugs The analysis of the association between prevalence of all drugs and drugspecific early discontinuation showed some degree of positive association – strongest for antihypertensive drugs r = 062 and antidepressants r = 043Conclusion This study confirmed our hypothesis that general practitioners with high levels of prescribing attain higher rates of early discontinuation compared with colleagues with low levels of prescribing not only with respect to antidepressants but also for various groups of drugs A common underlying mechanism is suggested but has to be verified in future studies

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