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
DOI:
https://doi.org/10.5324/nje.v11i1.530Sammendrag
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.
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