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Driving forces behind increasing cardiovascular drug utilization: a dynamic pharmacoepidemiological model.
Helle Wallach Kildemoes1, Henrik Støvring, Morten Andersen
1Research Unit for General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark. hwkildemoes@health.sdu.dk
British Journal of Clinical Pharmacology
|November 27, 2008
Summary
Cardiovascular drug use increased significantly due to higher incidence, not population aging. This trend is expected to continue, indicating a pharmacoepidemiological imbalance.
Area of Science:
- Pharmacoepidemiology
- Cardiovascular medicine
- Public health
Background:
- Cardiovascular drug utilization has been increasing.
- Understanding the drivers of this trend is crucial for healthcare planning.
Purpose of the Study:
- To investigate the primary factors contributing to the rising use of cardiovascular drugs.
- To differentiate the impact of population aging versus changes in treatment dynamics.
Main Methods:
- Utilized Danish register data from 1996-2006, tracking cardiovascular drug dispensing.
- Employed a semi-Markov model to analyze treatment incidence, discontinuation, and mortality.
- Assessed the influence of population aging using standardized intensities and prevalences.
Main Results:
- Cardiovascular drug treatment prevalence (ages >=20) rose by 39% (1996-2005), with intensity increasing by 109%.
- Increasing treatment incidence was the main driver, followed by declining discontinuation; population aging had a smaller impact.
- Treatment prevalence continued to increase even when incidence was held constant in models.
Conclusions:
- Rising cardiovascular drug use is driven by increased treatment incidence and prevalence, not solely population aging.
- Pharmacoepidemiological disequilibrium suggests continued growth in treatment prevalence.
- Interventions targeting incidence and discontinuation may be necessary to manage utilization trends.
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