Computerised data bases on prescription drug use and health care in the community of Tierp, Sweden: Experiences and challenges from a study of antidepressant-treated patients

Abstract

ABSTRACT

Much of our knowledge of drugs originates from clinical trials of drug efficacy performed on stringently

selected patient groups, often without multiple concurrent diseases. However, the effectiveness of treatment

under conditions of use in ordinary clinical practice may be very different to conditions in the

randomised clinical trial. Use of large computerised data bases and record linkage has thus become

increasingly common in pharmacoepidemiologic research. The greatest advantages of using routinely

collected data are the minimisation of study costs and time required to complete a study, considerations

that are particularly relevant for longitudinal studies. The advantages of using data bases also include the

possibility of obtaining large sample sizes and to retrospectively study long-term outcomes. The risk for

recall bias, a significant problem in interviews and questionnaires, is also reduced. However, computerised

data bases also have some potentially serious disadvantages, primarily in the areas of data validity

and data availability. The Tierp study, including individually based data bases of prescription drug use,

will be used here as an example of research. In this paper an example of a comprehensive data base study

concerning health care and drug utilisation in depressed patients is presented. Methodological considerations

in data base research are discussed in relation to experiences from the antidepressant study. A well

planned and research oriented computerised data base on prescription drugs represents an important tool

in the study of the outcome of drug treatment in real world clinical practice.