EVITA: a tool for the early evaluation of pharmaceutical innovations with regard to therapeutic advantage.

Background: New drugs are generally claimed to represent a therapeutic innovation. However, scientific evidence of a substantial clinical advantage is often lacking. This may be the result of using inadequate control groups or surrogate outcomes only in the clinical trials.

Verapamil inhibits L-type calcium channel mediated apoptosis in human colon cancer cells.

Purpose: Treatment with calcium channel blockers have been associated with increased colon cancer mortality in epidemiologic studies. We examined the potential expression and function of calcium channels in two human colon cancer cell lines.

Methods: Both primary (collected at operation) and commercially-available human colon cancer cell lines were used.

Predictors of acute myocardial infarction mortality in hypertensive patients treated in primary care: a population-based follow-up study in the Skaraborg Project.

Objective: To explore risk factors for acute myocardial infarction (AMI) mortality in hypertensive patients treated in primary care.

Design: Community-based cohort study.

Setting: Hypertension outpatient clinic in primary health care.

Refill adherence of antihyperglycaemic drugs related to glucose control (HbA1c) in patients with type 2 diabetes.

The aim of this study was to examine a potential association between: (1) refill adherence to antihyperglycaemic drugs and glucose control, and (2) adherence to antihyperglycaemic and cardiovascular drugs for the same patients. Consecutive patients with type 2 diabetes at six Swedish health centres were included. Refill adherence was determined from repeat prescriptions.

[Can Danish health care registries provide data for specific drug-related hospital admissions in type 2 diabetes?].

Introduction: Preventable drug-related hospital admissions (pDRAs) occur frequently but with unknown incidence in type 2 diabetes. The objective of this study was to assess the extent to which Danish health care registries can provide data for specific pDRA indicators in diabetes.

Materials And Methods: Operationalization of indicators was based on a random 10% sample of the Danish population from 2001-2003 with data from The National Patient Registry, The National Health Insurance Service Registry and The Register of Medicinal Product Statistics.

Can drug treatment prevent disease in common practice?

To assess whether drug treatment in common practice can prevent disease, we analysed four preventive cardiovascular randomised clinical trials (RCTs), expressing efficacy by 1-year Number Needed to Treat (NNT) in RCT and common practice effectiveness by the Disease Impact Number (DIN) in all subjects at risk and by the Population impact Number (PIN) in the entire population, based on a Swedish population survey. Adjustments were made for non-adherence. Calculations were made of alternative 1-year drug costs and number of years an average general practitioner (GP) would need to work in order to prevent one event using the actual treatment.

Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care.

Objective: To estimate the incidence and describe characteristics of preventable adverse drug events (pADEs) in ambulatory care.

Data Sources: Studies were searched in PubMed (1966-March 2007), International Pharmaceutical Abstracts (1970-December 2006), the Cochrane database of systematic reviews (1993-March 2007), EMBASE (1980-February 2007), and Web of Science (1945-March 2007). Key words included medication error, adverse drug reaction, iatrogenic disease, outpatient, ambulatory care, primary health care, general practice, patient admission, hospitalization, observational study, retrospective studies, health services research, and follow-up studies.

Low systolic blood pressure is associated with impaired cognitive function in the oldest old: longitudinal observations in a population-based sample 80 years and older.

Background And Aims: The primary aim of the present study was to examine whether there is an association between blood pressure and the risk of subsequent cognitive decline in the oldest old. Various factors associated with blood pressure and cognitive function were considered.

Methods: The study comprised 599 individuals of a population-based sample, 199 men (mean age at baseline 82.

Refill non-adherence to repeat prescriptions leads to treatment gaps or to high extra costs.

Objective: To determine the nature and extent of undersupply and the economic consequences of oversupply of medication among non-adherent patients.

Methods: This study used copies of repeat prescriptions (= multiple dispensations), collected during 1 week in 2002 at 16 Swedish community pharmacies. For patients with a refill adherence below 80%, treatment gaps were defined as the number of days they had no drug available.

Correlation of drug utilisation and morbidity at the municipality level. High use of antibiotics associated with low use of antihypertensives.

Objective: The aim of the study was to explore the relationship between Swedish drug sales data per municipality and morbidity per municipality. The morbidity was expressed as "sickness numbers" which are assumed to function as proxy for morbidity.

Methods: Sickness numbers per municipality were correlated to volumes of drug sales per municipality in 2003.

Increased introduction, advertising, and sales of preventive drugs during 1986-2002 in Sweden.

The objective of this study was to survey how introduction of new drugs and promotional activities influence drug sales in Sweden. All drugs on the Swedish market were categorized as curative, symptom-alleviating, substitutive, or preventive. The number of new drugs introduced, drug sales in volume and value, and the number of drug advertisements appearing in the major Swedish medical journal during 1986-2002 were determined for each of the 4 drug categories.

Neighborhood social participation, use of anxiolytic-hypnotic drugs, and women's propensity for disability pension: a multilevel analysis.

Aims: The increasing number of people on disability pension in Sweden is of concern for Swedish policy-makers, and there is a need for a better understanding of the mechanisms behind disability pension. We investigated (i) whether women living in the same neighborhood have a similar propensity for disability pension that relates to neighborhood social participation, and (ii) whether there is an association between anxiolytic-hypnotic drug (AHD) use and disability pension in women that is modified by the neighborhood context.

Methods: We used multilevel logistic regression with 12,156 women aged 45 to 64 (first level) residing in 95 neighborhoods (second level) in the city of Malmö (250,000 inhabitants), Sweden, who participated in the Malmö Diet and Cancer Study (1991-96).

Repeat prescriptions: refill adherence in relation to patient and prescriber characteristics, reimbursement level and type of medication.

Background: Repeat prescribing used in long-term pharmacotherapy is often associated with inadequate patient medication, including non-adherence. In this paper we explore patients' drug refill adherence with repeat prescriptions and relate refill data to patient age and gender, type of prescriber, type of prescribed drug, and reimbursement level.

Methods: During one week of 2002, copies of 3636 repeat prescriptions filled at 16 large Swedish pharmacies were collected.

Anxiolytic-hypnotic drug use associated with trust, social participation, and the miniaturization of community: a multilevel analysis.

The concept of social capital has gained wide interest in public health research in recent years. However, we suggest a concept that was introduced and developed by Fukuyama, named "miniaturization of community", as an alternative to that of social capital. The concept of miniaturization of community emphasizes that a high level of social participation can be accompanied by a low level of trust, both at the individual and at the community level, which may in turn result in social disorder and lack of social cohesion.

Survival in patients with hypertension treated in primary care. A population-based follow-up study in the Skaraborg Hypertension and Diabetes Project.

Objective: To explore risk factors for all-cause mortality in patients with hypertension.

Design: Community-based cohort study.

Setting: Hypertension outpatient clinic in primary health care.

Kinetics-effect relations of insulin-releasing drugs in patients with type 2 diabetes: brief overview.

Sulfonylureas and glinides have similar mechanisms of action but differ in receptor affinity and binding sites and in absorption and elimination rates. This promotes differences in potency, rate of onset, and duration of action. While prominent in single-dose studies, these differences have less importance during long-term sulfonylurea treatment: at ordinary dosages, rapid- and short-acting (glipizide) and slow- and long-acting (glyburide) sulfonylureas maintained continuously effective plasma levels and similar 24-h glucose control.

Pricing and costs of drugs in the United States and Sweden: a comparison based on drug acquisition costs at the patient outcome level.

Cost consequences of antihypertensive drug pricing were compared in the United States and Sweden. Because of price differences, US drug acquisition costs to prevent one cardiovascular event were 339%, 127%, and 22% higher using the most prescribed calcium channel blocker, angiotensin-converting enzyme inhibitor, and beta blocker, but 65% lower with hydrochlorothiazide. As thiazides are as effective as, but cheaper than, the alternatives, the costs of effective antihypertensive drug treatment may be pronouncedly reduced in both countries.