Programme no. 531-OP
Public Health
Drugs prescribed by general practitioners according to age, gender and socioeconomic status after adjustment for multimorbidity level
Jessica Skoog*1, Anders Beckman2, Patrik Midlöv3, Jan Sundquist4, Anders Halling5
1Avdelningen för Allmänmedicin,Institutionen för kliniska vetenskaper Malmö, Lunds universitet,205 02 Malmö,Sweden, 2Avdelningen för Allmänmedicin,Institutionen för kliniska vetenskaper Malmö, Lunds universitet,205 02 Malmö,Sweden, 3Avdelningen för Allmänmedicin,Institutionen för kliniska vetenskaper Malmö, Lunds universitet,205 02 Malmö,Sweden, 4Centrum för primärvårdsforskning,Institutionen för kliniska vetenskaper Malmö, Lunds universitet,205 02 Malmö,Sweden, 5Research Unit of General Practice,Institute of Public Health,Odense,Denmark
* = Presenting author
Objectives: In this study we examine the odds of having prescription drug use in the population and the rates of prescription drugs among patients, issued in primary health care, according to age, gender and socioeconomic status after adjustment for multimorbidity level.
Background: Age, gender and socioeconomic status have been shown to be associated with the use of prescription drugs, even after adjustment for multimorbidity. General practitioners have a holistic and patient-centred perspective and our hypothesis is that this may reflect on the prescription of drugs. In Sweden the patient may seek secondary care without a letter of referral and the liability of the prescription of drugs accompanies the patient, which makes it suitable for this type of research.
Results: After adjustment for multimorbidity, individuals 80 years or older had higher odds ratio (OR 3.37 (CI 95% 3.22-3.52)) and incidence rate ratio (IRR 6.24 (CI 95% 5.79-6.72)) for prescription drug use. Male individuals had a lower odds ratio of having prescription drugs (OR 0.66 (CI 95% 0.64-0.69)), but among patients males had a slightly higher incidence rate of drug use (IRR 1.06 (CI 95% 1.04-1.09)). Individuals with the highest income had the lowest odds ratio of having prescription drugs and individuals with the second lowest income had the highest odds ratio of having prescription drugs (OR 1.10 (CI 95% 1.07-1.13)). Individuals with the highest education had the lowest odds ratio of having prescription drugs (OR 0.61 (CI 95% 0.54-0.67)).
Material/Methods: Data were collected on all individuals above 20 years of age in Östergötland county with about 400 000 inhabitants in year 2006. The John Hopkins ACG Case-mix was used as a proxy for multimorbidity level. Odds ratio (OR) of having prescription drugs issued in primary health care in the population and rates of prescription drug use among patients in primary health care, stated as incidence rate ratio (IRR), according to age, gender and socioeconomic status were calculated and adjusted for multimorbidity.
Conclusion: Age, gender and socioeconomic status are associated with large differences in the use of prescribed drugs in primary health care, even after adjustment for multimorbidity level.
Points for discussion: Do general practitioners plan, evaluate and discontinue prescription drugs properly among the elderly patients?

Is the barrier to initiate pharmacological treatment higher for male patients compared to female patients?

To what extent does the patient's socioeconomic status affect the decision to initiate pharmacological treatment?

To what extent do general practitioners consider the patient's age, gender and socioeconomic status when initiating and choosing pharmacological treatment?