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Antithrombotic drugs and subarachnoid haemorrhage risk. A nationwide case-control study in Denmark.

https://arctichealth.org/en/permalink/ahliterature275809
Source
Thromb Haemost. 2015 Nov;114(5):1064-75
Publication Type
Article
Date
Nov-2015
Author
Anton Pottegård
Luis Alberto García Rodríguez
Frantz Rom Poulsen
Jesper Hallas
David Gaist
Source
Thromb Haemost. 2015 Nov;114(5):1064-75
Date
Nov-2015
Language
English
Publication Type
Article
Keywords
Aged
Aspirin - adverse effects - therapeutic use
Case-Control Studies
Denmark
Drug Therapy, Combination - adverse effects
Female
Fibrinolytic Agents - adverse effects - therapeutic use
Humans
Male
Middle Aged
Neurosurgical Procedures
Postoperative Complications - prevention & control
Risk
Subarachnoid Hemorrhage - epidemiology - etiology
Thrombosis - etiology - prevention & control
Ticlopidine - adverse effects - analogs & derivatives - therapeutic use
Vitamin K - antagonists & inhibitors
Abstract
The study objective was to investigate the relationship between use of antithrombotic drugs and subarachnoid haemorrhage (SAH). We identified patients discharged from Danish neurosurgery units with a first-ever SAH diagnosis in 2000 to 2012 (n=5,834). For each case, we selected 40 age-, sex- and period-matched population controls. Conditional logistic regression models were used to estimate odds ratios (aOR), adjusted for comorbidity, education level, and income. Low-dose aspirin (ASA) use for
PubMed ID
26202836 View in PubMed
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Association of Antithrombotic Drug Use With Subdural Hematoma Risk.

https://arctichealth.org/en/permalink/ahliterature281673
Source
JAMA. 2017 Feb 28;317(8):836-846
Publication Type
Article
Date
Feb-28-2017
Author
David Gaist
Luis Alberto García Rodríguez
Maja Hellfritzsch
Frantz Rom Poulsen
Bo Halle
Jesper Hallas
Anton Pottegård
Source
JAMA. 2017 Feb 28;317(8):836-846
Date
Feb-28-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Anticoagulants - administration & dosage - adverse effects
Aspirin - administration & dosage - adverse effects
Case-Control Studies
Comorbidity
Denmark - epidemiology
Drug Therapy, Combination
Female
Fibrinolytic Agents - administration & dosage - adverse effects
Hematoma, Subdural - epidemiology
Humans
Incidence
Male
Middle Aged
Odds Ratio
Platelet Aggregation Inhibitors - administration & dosage - adverse effects
Risk factors
Ticlopidine - administration & dosage - adverse effects - analogs & derivatives
Vitamin K - antagonists & inhibitors
Young Adult
Abstract
Incidence of subdural hematoma has been reported to be increasing. To what extent this is related to increasing use of antithrombotic drugs is unknown.
To estimate the association between use of antithrombotic drugs and subdural hematoma risk and determine trends in subdural hematoma incidence and antithrombotic drug use in the general population.
Case-control study of 10?010 patients aged 20 to 89 years with a first-ever subdural hematoma principal discharge diagnosis from 2000 to 2015 matched by age, sex, and calendar year to 400?380 individuals from the general population (controls). Subdural hematoma incidence and antithrombotic drug use was identified using population-based regional data (population: 484?346) and national data (population: 5.2 million) from Denmark. Conditional logistic regression models were used to estimate odds ratios (ORs) that were adjusted for comorbidity, education level, and income level.
Use of low-dose aspirin, clopidogrel, a vitamin K antagonist (VKA), a direct oral anticoagulant, and combined antithrombotic drug treatment.
Association of subdural hematoma with antithrombotic drug use, subdural hematoma incidence rate, and annual prevalence of treatment with antithrombotic drugs.
Among 10?010 patients with subdural hematoma (mean age, 69.2 years; 3462 women [34.6%]), 47.3% were taking antithrombotic medications. Current use of low-dose aspirin (cases: 26.7%, controls: 22.4%; adjusted OR, 1.24 [95% CI, 1.15-1.33]), clopidogrel (cases: 5.0%, controls: 2.2%; adjusted OR, 1.87 [95% CI, 1.57-2.24]), a direct oral anticoagulant (cases: 1.0%, controls: 0.6%; adjusted OR, 1.73 [95% CI, 1.31-2.28]), and a VKA (cases: 14.3%, controls: 4.9%; adjusted OR, 3.69 [95% CI, 3.38-4.03]) were associated with higher risk of subdural hematoma. The risk of subdural hematoma was highest when a VKA was used concurrently with an antiplatelet drug (low-dose aspirin and a VKA: 3.6% of cases and 1.1% of controls; adjusted OR, 4.00 [95% CI, 3.40-4.70]; clopidogrel and a VKA: 0.3% of cases and 0.04% of controls; adjusted OR, 7.93 [95% CI, 4.49-14.02]). The prevalence of antithrombotic drug use increased from 31.0 per 1000 individuals from the general population in 2000 to 76.9 per 1000 individuals in 2015 (P?75 years; n?=?4441) who experienced an increase from 55.1 per 100?000 person-years to 99.7 per 100?000 person-years (P?
PubMed ID
28245322 View in PubMed
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Medically treated exacerbations in COPD by GOLD 1-4: A valid, robust, and seemingly low-biased definition.

https://arctichealth.org/en/permalink/ahliterature276349
Source
Respir Med. 2015 Dec;109(12):1562-8
Publication Type
Article
Date
Dec-2015
Author
Truls S Ingebrigtsen
Jacob L Marott
Peter Lange
Jesper Hallas
Børge G Nordestgaard
Jørgen Vestbo
Source
Respir Med. 2015 Dec;109(12):1562-8
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Administration, Oral
Adrenal Cortex Hormones - administration & dosage
Adult
Aged
Analysis of Variance
Anti-Bacterial Agents - administration & dosage
Denmark - epidemiology
Drug Prescriptions - statistics & numerical data
Drug Therapy, Combination
Dyspnea - epidemiology
Forced Expiratory Volume - physiology
Humans
Kaplan-Meier Estimate
Middle Aged
Pulmonary Disease, Chronic Obstructive - drug therapy - epidemiology
Risk Assessment - methods
Vital Capacity - physiology
Abstract
We hypothesized that medically treated exacerbations in COPD defined as treatments with oral corticosteroids alone or in combination with antibiotics by register linkage with a nationwide prescription registry is a valid, robust and low-biased measure of exacerbations.
A total of 13,591 individuals with COPD in the Copenhagen General Population Study (2003-2013) were linked to the Danish prescription registry. Exacerbations were defined as dispensing of oral corticosteroids alone or in combination with antibiotics, dispensed less than four weeks apart during three years of follow-up. Construct validity of this definition of medically treated exacerbations was assessed by studying baseline determinants as well as by studying the association between GOLD 1 through 4 grades and time to first exacerbation during follow-up.
Among individuals with COPD, 964 individuals (7.1%) had at least one exacerbation during follow-up. At baseline, comparing those with versus without exacerbations during follow-up, FEV1, 72% of predicted vs. 85% (p
PubMed ID
26560643 View in PubMed
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The use of medication against attention deficit/hyperactivity disorder in Denmark: a drug use study from a patient perspective.

https://arctichealth.org/en/permalink/ahliterature122483
Source
Eur J Clin Pharmacol. 2013 Mar;69(3):589-98
Publication Type
Article
Date
Mar-2013
Author
Anton Pottegård
Bine Kjøller Bjerregaard
Dorte Glintborg
Lisbeth Sandal Kortegaard
Jesper Hallas
Søren Ilsøe Moreno
Author Affiliation
Clinical Pharmacology, Institute of Public Health, University of Southern Denmark, Winsløwparken 19, 2, 5000 Odense C, Denmark. apottegaard@health.sdu.dk
Source
Eur J Clin Pharmacol. 2013 Mar;69(3):589-98
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Attention Deficit Disorder with Hyperactivity - diagnosis - drug therapy - psychology
Central Nervous System Stimulants - administration & dosage - adverse effects - therapeutic use
Child
Child, Preschool
Denmark
Drug Prescriptions
Drug Therapy, Combination
Drug Utilization - trends
Drug Utilization Review
Guideline Adherence
Humans
Kaplan-Meier Estimate
Medication Adherence
Middle Aged
Off-Label Use
Patient Dropouts
Physician's Practice Patterns - trends
Practice Guidelines as Topic
Registries
Time Factors
Treatment Outcome
Young Adult
Abstract
Our aim was to characterize utilization patterns for drugs used to treat attention deficit/hyperactivity disorder (ADHD) on the level of the individual patient among Danish users, focusing on treatment duration, doses used, and concurrent use of ADHD and non-ADHD drugs.
Using the Danish Registry of Medicinal Product Statistics, we extracted data on 1,085,099 prescriptions for ADHD drugs issued to a total of 54,024 persons in the study period 1 January 1995 to 30 September 2011. For users in the final year of the study period, we further extracted 315,365 prescriptions for non-ADHD drugs. Drug utilization was characterized using descriptive statistics.
The mean duration of ADHD treatment was highest (3.6-4.2 years) for patients initiating therapy at a young age (age17). All age categories showed an increase in the average daily dosage of methylphenidate used from 2003 to 2010. Concomitant treatment with methylphenidate and atomoxetine was rare, as only 2 % of methylphenidate treatment overlapped with atomoxetine treatment. Nineteen percent of methylphenidate instant-release treatment overlapped with methylphenidate controlled-release treatment. Users of ADHD drugs across all age categories had an increased use of drugs related to the nervous system, especially antipsychotics [standardized morbidity rate (SMR), 6.4-19.5] and antiepileptics (SMR, 4.0-5.5).
We found certain traits that warrant further investigation: the apparent increase in average daily doses, the low adherence to treatment among off-label users, and the increased use of other psychotropic medication.
PubMed ID
22811260 View in PubMed
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