Skip to main content
Log in

Characteristics and drug utilization patterns for heavy users of prescription drugs among the elderly: a Danish register-based drug utilization study

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

The objectives of this study were to (1) identify and characterize heavy users of prescription drugs among persons aged 60 years and above; (2) investigate the association of demographic, socioeconomic, and health-related variables with being a heavy drug user; and (3) study the most frequently used drugs among heavy drug users and development in use over time.

Method

This is a descriptive study. Heavy drug users were defined as the accumulated top 1 percentile who accounted for the largest share of prescription drug use measured in number of dispensed defined daily doses (DDDs). The nationwide Danish registers were used to obtain data. Multivariable logistic binary regression was used to determine which factors were associated with being a heavy drug user.

Results

Heavy drug users among persons aged 60 years and above accounted for 6.8, 6.0, and 5.5 % of prescription drug use in 2002, 2007, and 2012, respectively. Male gender, those aged 60–69 years, being divorced, shorter education, low annual income, and recent hospitalization were all significantly associated with being in the top 1 percentile group of drug users (p < 0.05). The ten most frequently used drug classes among heavy drug users accounted for 75.4 % of their use in 2012, and five of these were cardiovascular drugs. The development over time for the ten most used drug classes followed the same pattern among heavy drug users and in the general population.

Conclusion

There is a skewed utilization of prescription drugs. Contrary to earlier findings, being male was associated with heavy prescription drug use both with respect to number of drugs used and drug expenditure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Al-Windi A, Elmfeldt D, Svardsudd K (2000) The relationship between age, gender, well-being and symptoms, and the use of pharmaceuticals, herbal medicines and self-care products in a Swedish municipality. Eur J Clin Pharmacol 56(4):311–317

    Article  CAS  PubMed  Google Scholar 

  2. Furu K, Straume B, Thelle DS (1997) Legal drug use in a general population: association with gender, morbidity, health care utilization, and lifestyle characteristics. J Clin Epidemiol 50(3):341–349

    Article  CAS  PubMed  Google Scholar 

  3. Nielsen MW, Hansen EH, Rasmussen NK (2003) Prescription and non-prescription medicine use in Denmark: association with socio-economic position. Eur J Clin Pharmacol 59(8–9):677–684. doi:10.1007/s00228-003-0678-z

    Article  PubMed  Google Scholar 

  4. Al-Windi A, Elmfeldt D, Svardsudd K (2004) Determinants of drug utilisation in a Swedish municipality. Pharmacoepidemiol Drug Saf 13(2):97–103. doi:10.1002/pds.864

    Article  PubMed  Google Scholar 

  5. Hovstadius B, Astrand B, Petersson G (2009) Dispensed drugs and multiple medications in the Swedish population: an individual-based register study. BMC Clin Pharmacol 9:11. doi:10.1186/1472-6904-9-11

    Article  PubMed Central  PubMed  Google Scholar 

  6. Pappa E, Kontodimopoulos N, Papadopoulos AA, Tountas Y, Niakas D (2011) Prescribed-drug utilization and polypharmacy in a general population in Greece: association with sociodemographic, health needs, health-services utilization, and lifestyle factors. Eur J Clin Pharmacol 67(2):185–192. doi:10.1007/s00228-010-0940-0

    Article  CAS  PubMed  Google Scholar 

  7. Zadoroznyj M, Svarstad BL (1990) Gender, employment and medication use. Soc Sci Med 31(9):971–978

    Article  CAS  PubMed  Google Scholar 

  8. Lech SV, Friedman GD, Ury HK (1975) Characteristics of heavy users of outpatient prescription drugs. Clin Toxicol 8(6):599–610. doi:10.3109/15563657508990085

    Article  CAS  PubMed  Google Scholar 

  9. Jyrkka J, Vartiainen L, Hartikainen S, Sulkava R, Enlund H (2006) Increasing use of medicines in elderly persons: a 5-year follow-up of the Kuopio 75+Study. Eur J Clin Pharmacol 62(2):151–158. doi:10.1007/s00228-005-0079-6

    Article  PubMed  Google Scholar 

  10. Isacson D, Haglund B (1989) Heavy users of prescription drugs–mortality and stability in use patterns. Scand J Prim Health Care 7(3):149–155

    Article  CAS  PubMed  Google Scholar 

  11. Hovstadius B, Astrand B, Persson U, Petersson G (2011) Acquisition cost of dispensed drugs in individuals with multiple medications—a register-based study in Sweden. Health Policy 101(2):153–161. doi:10.1016/j.healthpol.2011.03.003

    Article  PubMed  Google Scholar 

  12. Saastamoinen LK, Verho J (2013) Drug expenditure of high-cost patients and their characteristics in Finland. Eur J Health Econ 14(3):495–502. doi:10.1007/s10198-012-0393-8

    Article  PubMed  Google Scholar 

  13. Hallas J (2005) Drug utilization statistics for individual-level pharmacy dispensing data. Pharmacoepidemiol Drug Saf 14(7):455–463. doi:10.1002/pds.1063

    Article  PubMed  Google Scholar 

  14. Koper D, Kamenski G, Flamm M, Bohmdorfer B, Sonnichsen A (2013) Frequency of medication errors in primary care patients with polypharmacy. Fam Pract 30(3):313–319. doi:10.1093/fampra/cms070

    Article  PubMed  Google Scholar 

  15. Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, Farrar K, Park BK, Breckenridge AM (2004) Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ 329(7456):15–19. doi:10.1136/bmj.329.7456.15

    Article  PubMed Central  PubMed  Google Scholar 

  16. Thygesen LC, Daasnes C, Thaulow I, Bronnum-Hansen H (2011) Introduction to Danish (nationwide) registers on health and social issues: structure, access, legislation, and archiving. Scand J Public Health 39(7 Suppl):12–16. doi:10.1177/1403494811399956

    Article  PubMed  Google Scholar 

  17. Pedersen CB (2011) The Danish civil registration system. Scand J Public Health 39(7 Suppl):22–25. doi:10.1177/1403494810387965

    Article  PubMed  Google Scholar 

  18. Jensen VM, Rasmussen AW (2011) Danish education registers. Scand J Public Health 39(7 Suppl):91–94. doi:10.1177/1403494810394715

    Article  PubMed  Google Scholar 

  19. Baadsgaard M, Quitzau J (2011) Danish registers on personal income and transfer payments. Scand J Public Health 39(7 Suppl):103–105. doi:10.1177/1403494811405098

    Article  PubMed  Google Scholar 

  20. Kildemoes HW, Sorensen HT, Hallas J (2011) The Danish national prescription registry. Scand J Public Health 39(7 Suppl):38–41. doi:10.1177/1403494810394717

    Article  PubMed  Google Scholar 

  21. WHO Collaborating Centre for Drug Statistics Methodology, Guidelines for ATC classification and DDD assignment 2014 (2013). Oslo

  22. Lynge E, Sandegaard JL, Rebolj M (2011) The Danish national patient register. Scand J Public Health 39(7 Suppl):30–33. doi:10.1177/1403494811401482

    Article  PubMed  Google Scholar 

  23. Danmarks Statistik. http://www.dst.dk/da/OmDS.aspx. 10.06.2014

  24. Moller Pedersen K (2003) Pricing and reimbursement of drugs in Denmark. Eur J Health Econ 4(1):60–65. doi:10.1007/s10198-003-0165-6

    Article  CAS  PubMed  Google Scholar 

  25. Kildemoes HW, Stovring H, Andersen M (2008) Driving forces behind increasing cardiovascular drug utilization: a dynamic pharmacoepidemiological model. Br J Clin Pharmacol 66(6):885–895. doi:10.1111/j.1365-2125.2008.03282.x

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Madsen HK, Hallas J (2009) Udvikling i laegemiddelforbruget i Danmark. Ugeskr Laeger 171(10):775–777

    PubMed  Google Scholar 

  27. Mueller C, Schur C, O’Connell J (1997) Prescription drug spending: the impact of age and chronic disease status. Am J Public Health 87(10):1626–1629

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anna Birna Almarsdóttir.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Øymoen, A., Pottegård, A. & Almarsdóttir, A.B. Characteristics and drug utilization patterns for heavy users of prescription drugs among the elderly: a Danish register-based drug utilization study. Eur J Clin Pharmacol 71, 751–758 (2015). https://doi.org/10.1007/s00228-015-1849-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00228-015-1849-4

Keywords

Navigation