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  • 1.
    Bjerkeli, Pernilla J.
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Unit for Social Epidemiology, Faculty of Medicine, CRC, Lund University, Malmö, Sweden.
    Mulinari, Shai
    Unit for Social Epidemiology, Faculty of Medicine, CRC, Lund University, Malmö, Sweden / Department of Sociology, Faculty of Social Sciences, Lund University, Lund, Sweden.
    Zettermark, Sofia
    Unit for Social Epidemiology, Faculty of Medicine, CRC, Lund University, Malmö, Sweden.
    Merlo, Juan
    Unit for Social Epidemiology, Faculty of Medicine, CRC, Lund University, Malmö, Sweden.
    Sociodemographic patterns in pharmacy dispensing of medications for erectile dysfunction in Sweden2018In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 74, no 2, p. 209-218Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The purpose of this study is to investigate the relationship between sociodemographic factors and pharmacy dispensing of medications for erectile dysfunction (ED) in the general population of middle-aged and elderly men. By considering a number of medical conditions that could promote or contraindicate use of ED medication, the analysis could help capture prescription patterns that might not be explained by medical needs.

    METHODS: Individual-level pharmacy dispensing data from 2006 for a population-based cohort of 216,148 men aged 45-79 years in the county Scania, Sweden, were analysed. Multiple logistic regression was applied, and area under the receiver operating characteristic curve (AUC) was calculated to quantify the discriminatory accuracy (DA) of the associations. National trends in pharmacy dispensing of ED medication between 2006 and 2016 were also analysed.

    RESULTS: Pharmacy dispensing of ED medication increased between 2006 and 2016, particularly among men aged 65-79 years (from 6.8 to 9.2%). Dispensing of ED medication was positively associated with higher socioeconomic position, and divorced and widowed men were more likely to fill a prescription with ED medication than married men. These associations remained after adjusting for medical conditions. The DA of the associations was, however, rather low (AUC = 0.69 among 45-64 year olds and AUC = 0.65 among 65-79 year olds).

    CONCLUSIONS: Pharmacy dispensing of ED medication seem linked to the individuals socioeconomic position, age and marital status suggesting sociodemographic disparities in the pharmacy dispensing targeting sexual function. However, the low DA of the associations shows the limited capacity of these factors to predict ED medication use at the individual level.

  • 2.
    Mårdby, Ann-Charlotte
    et al.
    Research and Development, Sahlgrenska University Hospital, Gothenburg, Sweden / Section of Epidemiology and Social Medicine, Department of Public Health and Community Medicine at Institute of Medicine, University of Gothenburg, Gothenburg, Sweden / Novo Nordisk A/S, Malmö, Sweden.
    Schiöler, Linus
    Section of Occupational and Environmental Medicine, Department of Public Health and Community Medicine at Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Andersson Sundell, Karolina
    Section of Epidemiology and Social Medicine, Department of Public Health and Community Medicine at Institute of Medicine, University of Gothenburg, Gothenburg, Sweden / Medical Evidence and Observational Research, AstraZeneca, Mölndal, Sweden.
    Bjerkeli, Pernilla
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Nordic School of Public Health, Gothenburg, Sweden.
    Lesén, Eva
    Nordic Health Economics AB, Gothenburg, Sweden.
    Jönsson, Anna K.
    Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
    Adherence to antidepressants among women and men described with trajectory models: a Swedish longitudinal study2016In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 72, no 11, p. 1381-1389Article in journal (Refereed)
    Abstract [en]

    The purpose of this study are to analyse adherence to antidepressant treatment over 2 years in Sweden among women and men who initiated treatment with citalopram and to identify groups at risk of non-adherence using trajectory models. The study population, including individuals 18-85 years who initiated citalopram use between 1 July 2006 and 30 June 2007, was identified in the Swedish Prescribed Drug Register and followed for 2 years. Adherence was estimated with continuous measure of medication acquisition (CMA) and group-based trajectory modelling, a method which describes adherence patterns over time by estimating trajectories of adherence and the individual's probability of belonging to a specific trajectory. The study population included 54,248 individuals, 64 % women. Mean CMA was 52 % among women and 50 % among men (p < 0.001). Five different adherence patterns (Trajectories) were identified. Similar proportion of women and men belonged to each Trajectory. Around 29 % of the women and 27 % of the men belonged to the Trajectory which showed full adherence throughout the 2-year study period. The other four Trajectories showed adherence that declined to different degrees and at different stages in time. Having low socioeconomic status was more common among individuals in Trajectories showing declining adherence than in the adherent Trajectory. Using trajectory modelling, five Trajectories describing different patterns of adherence to citalopram treatment over time were identified. A large proportion discontinued treatment early and having low socioeconomic status increased the risk of being non-adherent.

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