Do patients initiate therapy? Primary non-adherence to statins and antidepressants in Iceland.

BACKGROUND: Primary non-adherence occurs when a drug has been prescribed but the patient fails to have it dispensed at the pharmacy. AIMS: To assess primary non-adherence to statins and antidepressants in Iceland, the association of demographic factors with primary non-adherence, and the time from when a prescription is issued until it is dispensed. METHODS: Data on patients receiving a new prescription for a statin or an antidepressant from the Primary Health Care database were linked with dispensing histories from The Icelandic Prescription Database. The proportion of patients who did not have their prescription dispensed within a year from issuing (primary non-adherent) was assessed, as well as the time from issue until dispensing. Associations between demographic factors and primary non-adherence were estimated using logistic regression. RESULTS: The overall primary non-adherence was 6.3% and 8.0% for statins and antidepressants, respectively. The majority of patients had their prescription dispensed within 7 days (85% for statins, 87% for antidepressants). Being disabled and receiving a prescription for an expensive drug was associated with higher rates of primary non-adherence. CONCLUSION: The rate of primary non-adherence to statins and antidepressants in Iceland is low. Vulnerable groups such as the disabled should be given special attention when new drugs are prescribed.

Use of ADHD drugs in the Nordic countries: a population-based comparison study.

OBJECTIVE: To compare national use of attention-deficit/hyperactivity disorder (ADHD) drugs between five Nordic countries. METHOD: A population-based drug utilisation study based on nationwide prescription databases, covering in total 24 919 145 individuals in 2007. ADHD drugs defined according to the World Health Organization Anatomic Therapeutic Chemical classification system as centrally acting sympathomimetics (N06BA). RESULTS: The 2007 prevalence of ADHD drug use among the total Nordic population was 2.76 per 1000 inhabitants, varying from 1.23 per 1000 in Finland to 12.46 per 1000 in Iceland. Adjusting for age, Icelanders were nearly five times more likely than Swedes to have used ADHD drugs (Prev.Ratio = 4.53, 95% CI: 4.38-4.69). Prevalence among boys (age 7-15) was fourfold the prevalence among girls (Prev.Ratio = 4.28, 95% CI: 3.70-4.96). The gender ratio was diminished among adults (age 21 +) (Prev.Ratio = 1.24, CI: 1.21-1.27). CONCLUSION: A considerable national variation in use of ADHD drugs exists between the Nordic countries.

Socioeconomic differences in children's use of physician services in the Nordic countries.

OBJECTIVE: To assess the relation between socioeconomic factors and the use of physician services among children and whether variations of the level of co-payment are correlated with different levels of inequalities in health services use. DESIGN: Description of the socioeconomic differences in the use of health care using data from countrywide postal surveys to parents. SETTING: The five Nordic countries in 1996. SUBJECTS: Samples of 15 000 children aged 2-17 years: 3000 children at random, from the national registry in each country. MAIN OUTCOME MEASURE: Odds ratios of use of GP, specialist, and hospital services between children according to the educational level of both parents and the disposable income of the family, for all countries together and for each country separately. Odds ratios were adjusted for age, sex, urbanisation grade, and health status. RESULTS: There was little difference in the use of GP services according to socioeconomic factors. Parents from lower socioeconomic groups used telephone services of physicians less than parents from the higher groups and children of lower socioeconomic groups were seen less often by specialists. The reverse was true for hospitalisation of the children. The differential use of those three types of services was more marked in Denmark, Finland and Norway than in Iceland and Sweden. When controlled for other socioeconomic factors, the largest differences were observed according to the education of the mother. CONCLUSION: The specialist services and use of telephone services for children in the Nordic countries do not meet the criteria of equal use for equal need whereas the GP services and hospital services do to some extent. The education of the mother is a more important determinant than income for the use of each service.

Socioeconomic differences in health and well-being of children and adolescents in Iceland.

STUDY OBJECTIVE: To assess differences in health, healthcare use and well-being of children according to their socioeconomic situation. DESIGN: Part of a larger cross-sectional survey on health and well-being of children and their parents in the Nordic countries. SETTING: Iceland. PARTICIPANTS: A questionnaire was sent to the parents of a nationally representative sample of 3,007 school children aged two to seventeen years. MAIN RESULTS: The SES indicators used were education and occupation of both parents and the disposable income of the family. Logistic regression models were used for the analysis. Children of lower SES were found to have worse health and well-being than those of higher SES. Children of lower SES appeared to use doctor's services to the same degree as children of higher SES, especially after differences in ill health were taken into account. CONCLUSION: The association between SES and health status and well-being in adulthood can already be detected in childhood, even in an egalitarian country with a homogeneous population.

[Clinical chemistry and bacteriological testing in Iceland 1990.].

In this article we present the number and composition of clinical laboratory testing, both haematological, biochemical and bacteriological, performed at hospitals, primary care centers and private clinics in Iceland, in the year 1990. Inquiries were sent to 85 institutions, 52 (61%) responded. The number of assays performed at the laboratories/institutions not responding was estimated. The total number of assays performed in 1990 at these Icelandic institutions was 1.7 million which equals to 6.7 tests per person. Comparison to a similar investigation of assays done in 1982 showed that for those institutions which participated both years the number of tests other than bacteriological tests had increased by 23.2%. Tests done at larger hospitals had increased by 30%, at intermediate sized hospitals they had increased by 14.5%, and testing at primary care centers had decreased by 10% between 1982 and 1990. Bacteriological and clinical chemistry tests increased significantly or by 53% and 49% respectively. On the other hand hematological tests increased only by 1% and tests on urine decreased by 25%. By far the most common assay performed was blood count, ESR came second both years.