Effect of persistent use of antihypertensives on blood pressure goal attainment.

Objective: Discontinuation rates with antihypertensive drugs in real life are high. The present study investigates the relationship between persistence with antihypertensive drugs (AHT) and blood pressure (BP) goal attainment in daily clinical practice.

Methods: In the PHARMO Record Linkage System, which includes drug dispensing and hospital records for > 2 million inhabitants in the Netherlands, new users of AHT > or = 18 years were identified for the period 1999-2004.

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.

The effect of discontinuation of antihypertensives on the risk of acute myocardial infarction and stroke.

Objective: Adherence to antihypertensive drug treatment is suboptimal. The present study investigates the effect of early treatment discontinuation with antihypertensive drugs on the risk of acute myocardial infarction (AMI) or stroke in daily clinical practice.

Methods: In the PHARMO Record Linkage System, which includes all records of drug dispensings and hospitalisations for > or = 2 million subjects in the Netherlands, new users of antihypertensive (AHT) drugs > or = 18 years of age were studied during the period 1 January 1993 - 1 October 2002 to determine the risk of AMI or stroke related to persistence with AHT.

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.

Persistence with antihypertensives related to formulation: the case of nifedipine.

Background: Controlled-release dosage forms may enhance persistence with therapy because of reduced dosing frequency and fewer adverse effects.

Objective: To assess the differences in persistent use of nifedipine between once-daily nifedipine gastrointestinal therapeutic system (GITS) and twice-daily nifedipine retard formulations.

Methods: Incident nifedipine users were selected from January 1992 to December 2001 from the PHARMO database, including drug-dispensing records and hospital records of more than one million subjects in the Netherlands.

Selective prescribing of atypical antipsychotics.

Purpose: The aim of the study was to investigate whether the most recent introduced atypical antipsychotics olanzapine and risperidone were preferentially prescribed to patients susceptible to develop extrapyramidal side effects (EPS) and those not responding adequately to typical antipsychotics.

Methods: Data were obtained from the Dutch PHARMO system that includes complete medication and hospital admission records of 675 000 residents of 14 Dutch cities. A total number of 129 new users of olanzapine and 142 new users of risperidone as well as 507 new users of typical antipsychotic drugs were identified from our database in the period of 1996-1998.

Treatment patterns and health care costs of mebeverine-treated IBS patients: a case-control study.

Background: Irritable bowel syndrome (IBS) is a functional disorder affecting the quality of life of patients. In the Netherlands, mebeverine is currently the only medical treatment registered for IBS, although its efficacy is considered disputable.

Objective: To assess treatment patterns and associated health care cost in mebeverine users relative to matched controls.