Education and drug use in Sweden--a nationwide register-based study

To analyse educational variations in prescriptions dispensed in Sweden. A better knowledge of the use of drugs in the population, including socioeconomic distribution, is a prerequisite in efforts to estimate whether drugs are being prescribed and used according to need. This knowledge may also facilitate the identification of selection or confounding factors when analysing outcome or adverse side effects of drug treatment.

All prescriptions dispensed during 2006 for 22 different categories of drugs were analysed in the Swedish Prescribed Drug Register. Each prescription was linked by a unique personal identification number (PIN) to the National Education Register. In total, analyses covered 1,557,740 men and 1,568,175 women aged 45-74.

Those with low education were generally at higher risk of having drugs, odds ratios (ORs) varying from 1.2 to 2. Most differences appeared to be of the same magnitude as those found in studies of the relation between education and disease incidence and prevalence, that is drugs may be prescribed and dispensed according to need. However, there are some drugs, such as antibiotics, sildenafil, hormone replacement drugs, anti-migraine drugs and angiotensin receptor blockers (ARB), where people with higher education have higher consumption than is expected from incidence and prevalence data.

There are rather large differences in drug utilization between groups of different educational levels. Mostly these disparities seem to reflect differences in need, but there are examples of inequalities in drug use.