Understanding adherence to therapeutic guidelines: A multilevel analysis of statin prescription in the Skaraborg Primary Care Database

European Journal of Clinical Pharmacology

Volumn 67, Issue 4, 2011, Pages 415-423

  Hjerpe, Per ^a,b,d   Ohlsson, Henrik ^b   Lindblad, Ulf ^c   Boström, Kristina Bengtsson ^a   Merlo, Juan ^b  

^a Skaraborg Primary Care   (Sweden)

^b LUND UNIVERSITY   (Sweden)

^c UNIVERSITY OF GOTHENBURG   (Sweden)

^d FoU centrum Primärvården Skaraborg ^*  (Sweden)

Author keywords

Drug prescriptions; Medical records systems (computerized); Multilevel analysis; Primary health care; Quality assurance, health care

Indexed keywords

ANGIOTENSIN RECEPTOR ANTAGONIST; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; CARDIOVASCULAR AGENT; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIURETIC AGENT; FIBRIC ACID DERIVATIVE; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; NITRIC ACID DERIVATIVE; POTASSIUM SPARING DIURETIC AGENT; PRAVASTATIN; RESIN; SIMVASTATIN; THIAZIDE DIURETIC AGENT;

ADULT; AGED; ARTICLE; CONTROLLED STUDY; DATA BASE; DECENTRALIZATION; FEMALE; HEALTH CARE COST; HEALTH CENTER; HUMAN; MALE; OCCUPATION; OUTCOME ASSESSMENT; PHYSICIAN; PHYSICIAN ATTITUDE; PRACTICE GUIDELINE; PRESCRIPTION; PREVALENCE; PRIMARY MEDICAL CARE; PRIORITY JOURNAL; PUBLIC HEALTH; SEX DIFFERENCE; SWEDEN;

ADULT; AGE FACTORS; AGED; AGED, 80 AND OVER; DATABASES, FACTUAL; DRUG PRESCRIPTIONS; FEMALE; GUIDELINE ADHERENCE; HUMANS; HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS; MALE; MIDDLE AGED; MULTILEVEL ANALYSIS; PHYSICIAN'S PRACTICE PATTERNS; PRIMARY HEALTH CARE; SEX FACTORS;

EID: 79954592846     PISSN: 00316970     EISSN: None     Source Type: Journal    
DOI: 10.1007/s00228-010-0973-4     Document Type: Article

References (32)

1. Grimshaw J, Thomas R, Maclennan G, Fraser C, Ramsay C, Vale L et al (2004) Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess 8(6)
2. Socialstyrelsen (ed) (2006) God vård-om ledningssystem för kvalitet och patientsäkerhet I hälso-och sjukvården. (Appropriate care-about management for quality and patient security in health and medical care) (in Swedish). Stockholm: Socialstyrelsen
3. RG Brindis C Sennett 2003 Physician adherence to clinical practice guidelines: does it really matter? Am Heart J 145 1 13 15 12514648 10.1067/mhj.2003.25 (Pubitemid 36034491)
4. Koutsavlis AT (2001) Disseminating practice guidelines to physicians. Institut National de Santé Publique du Québec, Québec City
5. Thorsen T, Mäkelä M (eds) (1999) Changing professional practice-theory and practice of clinical guidelines implementation. Danish Institute for Health Services Research and Development, Copenhagen
6. Socialstyrelsen (ed) (2007) En uppföljning av lä kemedelskommitéernas arbete. Hur påverkas läkemedelsanvä ndningen (A follow-up of the effort of the drug committees. How does it affect the drug use?) (in Swedish). Socialstyrelsen, Stockholm
7. WN Kasje P Denig RE Stewart PA de Graeff FM Haaijer-Ruskamp 2005 Physician, organisational and patient characteristics explaining the use of angiotensin converting enzyme inhibitors in heart failure treatment: a multilevel study Eur J Clin Pharmacol 61 2 145 151 15761751 10.1007/s00228-005- 0897-6 1:CAS:528:DC%2BD2MXjslOrt7c%3D (Pubitemid 40674747)
8. H Ohlsson U Lindblad T Lithman B Ericsson UG Gerdtham A Melander, et al. 2005 Understanding adherence to official guidelines on statin prescribing in primary health care-a multi-level methodological approach Eur J Clin Pharmacol 61 9 657 665 16133551 10.1007/s00228-005-0975-9 1:STN:280:DC%2BD2Mrls1Cqtw%3D%3D
9. H Ohlsson J Merlo 2007 Understanding the effects of a decentralized budget on physicians compliance with guidelines for statin prescription; a multilevel methodological approach BMC Health Serv Res 7 68 17488496 10.1186/1472-6963-7-68 (Pubitemid 46849117)
10. F Sjöqvist M-L Dahl L Gustafsson L-O Hensjö 2002 Drug therapeutics committees: a Swedish experience WHO Drug Inf 16 207 213 (Pubitemid 36262226)
11. Socialdepartementet. Lag (1996:1157) om läkemedelskommittéer. [Law (1996:1157) about drug committees] (in Swedish). Stockholm
12. H Ohlsson B Chaix J Merlo 2009 Therapeutic traditions, patient socio-economic characteristics and physicians' early new drug prescribing-a multilevel analysis of rosuvastatin prescription in South Sweden Eur J Clin Pharmacol 65 2 141 150 18836707 10.1007/s00228-008-0569-4
13. H Ohlsson J Merlo 2009 Is physician adherence to prescription guidelines a general trait of health care practices or dependent on drug type?-a multilevel logistic regression analysis in South Sweden Pharmacoepidemiol Drug Saf 18 8 682 690 19437457 10.1002/pds.1767
14. P Hjerpe J Merlo H Ohlsson K Bengtsson-Boström U Lindblad 2010 Validity of registration of ICD codes and prescriptions in a research database in Swedish primary care a cross-sectional study in Skaraborg primary care database (SPCD) BMC Med Inform Decis Mak 10 23 20416069 10.1186/1472-6947-10-23
15. World Health Organization (WHO). About the ATC/DDD system. Available at: http://www.whocc.no/atcddd/. WHO, Geneva
16. Goldstein H (2003) Multilevel statistical models. 3rd ed. Hodder Arnold, London
17. Snijders T, Bokser R (1999) Multilevel analysis: an introduction to basic and advanced multilevel modeling. Sage Publications, Thousand Oaks
18. K Larsen J Merlo 2005 Appropriate assessment of neighborhood effects on individual health: integrating random and fixed effects in multilevel logistic regression Am J Epidemiol 161 1 81 88 15615918 10.1093/aje/kwi017 (Pubitemid 40053282)
19. K Larsen JH Petersen E Budtz-Jorgensen L Endahl 2000 Interpreting parameters in the logistic regression model with random effects Biometrics 56 3 909 914 10985236 10.1111/j.0006-341X.2000.00909.x 1:STN:280: DC%2BD3M%2Fms1ygsg%3D%3D
20. Rasbash J, Steele F, Browne W (2003) A user's guide to MLwiN, version 2.0 Documentation version 2.1e. London: Centre for Multilevel Modelling, Institute of Education, University of London
21. MA Brookhart DH Solomon P Wang RJ Glynn J Avorn S Schneeweiss 2006 Explained variation in a model of therapeutic decision making is partitioned across patient, physician, and clinic factors J Clin Epidemiol 59 1 18 25 16360557 10.1016/j.jclinepi.2005.07.005 (Pubitemid 41797471)
22. B Braumoeller 2006 Explaining variance; or, stuck in a moment we can't get out of Polit anal 14 268 290 10.1093/pan/mpj009 (Pubitemid 43941856)
23. J Merlo 2003 Multilevel analytical approaches in social epidemiology: measures of health variation compared with traditional measures of association J Epidemiol Community Health 57 8 550 552 12883048 10.1136/jech.57.8.550 1:STN:280:DC%2BD3szltFWhtw%3D%3D (Pubitemid 36930274)
24. Rasbash J, Browne W, Goldstein H, Yang M, Plewis I, Healy M et al (2003) Modelling the variance as a function of explanatory variables. A user's guide to MLwiN. version 2.0. Documentation version 2.1e. Institute of Education, University of London, London
25. J Merlo B Chaix M Yang J Lynch L Råstam 2005 A brief conceptual tutorial of multilevel analysis in social epidemiology-interpreting neighbourhood differences and the effect of neighbourhood characteristics on individual health J Epidemiol Community Health 59 1022 1028 16286487 10.1136/jech.2004.028035 (Pubitemid 41728264)
26. N Black 1996 Why we need observational studies to evaluate the effectiveness of health care Br Med J 312 7040 1215 1218 1:STN:280: DyaK283hsVGluw%3D%3D (Pubitemid 26136714)
27. J Merlo B Chaix 2006 Neighbourhood effects and the real world beyond randomized community trials: a reply to Michael J Oakes Int J Epidemiol 35 5 1361 1363 17008359 10.1093/ije/dyl211 (Pubitemid 44605570)
28. S Schneeweiss 2007 Developments in post-marketing comparative effectiveness research Clin Pharmacol Ther 82 2 143 156 17554243 10.1038/sj.clpt.6100249 1:STN:280:DC%2BD2svhtFSlsQ%3D%3D (Pubitemid 47075343)
29. G Sorensen K Emmons MK Hunt D Johnston 1998 Implications of the results of community intervention trials Annu Rev Public Health 19 379 416 9611625 10.1146/annurev.publhealth.19.1.379 1:STN:280:DyaK1c3nsVGmuw%3D%3D (Pubitemid 28279937)
30. JC LaRosa J He S Vupputuri 1999 Effect of statins on risk of coronary disease: a meta-analysis of randomized controlled trials J Am Med Assoc 282 24 2340 2346 10.1001/jama.282.24.2340 1:CAS:528:DC%2BD3cXjsF2ntQ%3D%3D (Pubitemid 30013066)
31. A Mehner U Lindblad L Rastam KB Bostrom 2008 Cholesterol in women at high cardiovascular risk is less successfully treated than in corresponding men. The Skaraborg hypertension and diabetes project Eur J Clin Pharmacol 64 8 815 820 18389228 10.1007/s00228-008-0482-x
32. Crump B (2007) The good indicators guide: understanding how to use and choose indicators. NHS Institute for Innovation and Improvement, Coventry, UK