Large impact of antidiabetic drug treatment and hospitalizations on economic burden of diabetes mellitus in The Netherlands during 2000 to 2004.

Objective: To estimate the burden of diabetes mellitus (DM) and its complications in The Netherlands.

Methods: The PHARMO Record Linkage System comprised among others linked drug dispensing, hospital and clinical laboratory data from approximately 2.5 million individuals in The Netherlands.

Effect of non-persistent use of oral glucose-lowering drugs on HbA1c goal attainment.

Objectives: The aim of this study was to quantify the effect of non-persistence with oral glucose-lowering drugs (OGLD) on HbA(1c) goal attainment (<7%) in daily practice.

Methods: From the PHARMO Record Linkage System comprising among others linked drug dispensing and clinical laboratory data from approximately 2.5 million individuals in the Netherlands, new users of OGLD in the period 1999-2004 were identified.

Determinants of non-compliance with bisphosphonates in women with postmenopausal osteoporosis.

Objective: To identify determinants of non-compliance with bisphosphonates in women with postmenopausal osteoporosis. By considering the year of the introduction of weekly bisphosphonates important additional information is obtained.

Methods: New female users of daily or weekly alendronate or risedronate between 1999 and 2004, aged >or= 45 years were identified from PHARMO RLS, including drug-dispensing and hospitalisation data of > 2 million residents of the Netherlands.

Extent of uncontrolled disease and associated medical costs in severe asthma--a PHARMO study.

Objective: Asthma is a major public health problem with considerable economic impact. The highest costs being observed in patients with severe asthma. Furthermore, despite the use of recommended therapies, asthma control can still be poor.

Treatment with inhaled corticosteroids in asthma is too often discontinued.

Purpose: To study persistence with inhaled corticosteroids (ICS) and its determinants in asthma-patients.

Methods: From the PHARMO database, asthma-patients (age < 35 years) with a first dispensing for ICS in 1999-2002 and > or = 2 dispensings in the first year were included. Persistence during the first year was defined as the number of days from start to time of first failure to continue renewal of the initial ICS.

Higher persistence with valsartan compared with enalapril in daily practice.

Objective: To compare persistence with valsartan and enalapril in daily practice.

Methods: The PHARMO Record Linkage System includes various data registries including drug dispensing and hospitalizations for > or =2 million subjects in the Netherlands. Patients newly treated with valsartan or enalapril in the period of 1999-2002 were selected.

Incidence of cardiovascular events in breast cancer patients receiving chemotherapy in clinical practice.

Purpose: To assess the incidence of cardiovascular events among breast cancer patients after chemotherapy.

Methods: Women > or =18 years with a breast tumour who received chemotherapy in 1992-2003 were selected from the PHARMO RLS. Chemotherapy with anthracyclines, a combination of anthracyclines and taxanes or second line treatment with trastuzumab was classified as cardiotoxic.

Medicinal cannabis in oncology.

In The Netherlands, since September 2003, a legal medicinal cannabis product, constituting the whole range of cannabinoids, is available for clinical research, drug development strategies, and on prescription for patients. To date, this policy, initiated by the Dutch Government, has not yet led to the desired outcome; the amount of initiated clinical research is less than expected and only a minority of patients resorts to the legal product. This review aims to discuss the background for the introduction of legal medicinal cannabis in The Netherlands, the past years of Dutch clinical experience in oncology practice, possible reasons underlying the current outcome, and future perspectives.

Large-scale stopping and switching treatment with COX-2 inhibitors after the rofecoxib withdrawal.

Purpose: To compare treatment changes after the rofecoxib withdrawal with changes occurring normally and to re-assess 12 months afterwards.

Methods: The PHARMO database comprised medication and hospital discharge records of over 3 million inhabitants in the Netherlands. The Study cohort included chronic coxib users with a coxib prescription on 30th September 2004; the Reference cohort others with a coxib prescription on 1st June 2004.

Enhanced persistence with tiotropium compared with other respiratory drugs in COPD.

Background: Tiotropium is a once-daily inhaled anticholinergic maintenance treatment with demonstrated effectiveness in chronic obstructive pulmonary disease (COPD).

Objective: To compare persistence of tiotropium-use with other inhaled respiratory drugs in COPD in current clinical practice.

Methods: The PHARMO database includes, among others, drug-dispensing and hospital discharge records for 2> or = million subjects in the Netherlands.

Determinants of persistence with bisphosphonates: a study in women with postmenopausal osteoporosis.

Background: Although bisphosphonates are useful in the management of osteoporosis, patients often discontinue treatment.

Objectives: The aims of this study were to investigate persistence with bisphosphonates, and to assess whether the dose interval influenced persistence, among women with postmenopausal osteoporosis.

Methods: Data were obtained from the PHARMO Record Linkage System, which includes, among other databases, drug-dispensing records from community pharmacies linked to hospital discharge records of > 1 million subjects in defined areas in The Netherlands.

Differences in antihypertensive drug persistence associated with drug class and gender: a PHARMO study.

Objective: The objective of the study is to investigate factors related to treatment persistence among users of antihypertensive (AHT) drugs in daily practice.

Methods: Data for this study were obtained from the PHARMO database including pharmacy records and hospitalizations in the Netherlands (n=950,000). Patients who newly received AHT therapy (n=17,113) between 1997 and 2001 were selected.

Main comedications associated with major bleeding during anticoagulant therapy with coumarins.

Objective: To study the main comedications associated with major bleeding during anticoagulant therapy with coumarins in a non-selected population under everyday circumstances.

Methods: The study population for this retrospective cohort study included all new users of phenprocoumon or acenocoumarol aged 40-80 years, during the period 1992-2000 in the PHARMO Record Linkage System. All patients were followed until the last dispensing of phenprocoumon or acenocoumarol, the first bleeding complication requiring hospitalization, death, or the end of the study period.

Antipsychotic drugs may worsen metabolic control in type 2 diabetes mellitus.

Background: Several studies have indicated that type 2 diabetes mellitus is more common among schizophrenic patients than in the general population. In this study, we investigated whether the use of antipsychotic drugs in patients with diabetes leads to worsening of glycemic control.

Method: In this cohort study, patients with newly diagnosed type 2 diabetes were selected from the PHARMO Record Linkage System, which comprises pharmacy records for all 320000 residents of 6 Dutch cities.

Antihypertensive drug therapy and the risk of lower extremity amputations in pharmacologically treated type 2 diabetes patients.

Purpose: The objective of this study was to determine the association between different antihypertensive drug therapies and lower extremity amputations (LEAs) in type 2 diabetes patients.

Methods: Data were obtained from the PHARMO Record Linkage System comprising pharmacy records and data on hospitalisations for all 450,000 residents of eight Dutch cities. In a nested case-control study among 12,140 type 2 diabetes patients who used antihypertensive drugs, 26 cases with a first LEA and 94 controls without a LEA matched on age, sex and calendar time were identified.

Refill compliance in type 2 diabetes mellitus: a predictor of switching to insulin therapy?

Objective: To assess whether switching to insulin therapy in patients with type 2 diabetes mellitus is associated with medication refill compliance of oral hypoglycemic agents.

Research Design And Methods: The PHARMO Record Linkage System was used as data source for this study. Patients with newly treated type 2 diabetes mellitus were defined as subjects in whom oral hypoglycemic therapy was initiated between 1991 and 1998.

Cardiovascular risk factors and diseases precede oral hypoglycaemic therapy in patients with type 2 diabetes mellitus.

Although patients with type 2 diabetes mellitus and cardiovascular disease share common risk factors, the link between these diseases remains largely unexplained. In this case-control study, the earlier use of cardiovascular drugs (before the diagnosis of diabetes) was investigated among cases with type 2 diabetes mellitus and controls without diabetes. Using the PHARMO database, we identified 4,864 patients who were prescribed oral hypoglycaemic agent (OHA) therapy between 1985-1998 in the Netherlands.