Health Databases in Saskatchewan

Downey, Winanne; Beck, Patricia; McNutt, Mary; Stang, Mary Rose; Osei, William; Nichol, Jim

doi:10.1002/0470842555.ch20

Cited by 89 publications

(87 citation statements)

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“…Despite such limitations, the Saskatchewan Health databases are a worldrenowned resource for medical information data on a large population, are commonly used in health research, and validation checks of the data are a quality control feature of the databases. 26,27 In conclusion, the results reported here suggest that the initial antihypertensive drug class is associated with different persistence or treatment discontinuation rates, which potentially lead to varying utilization of limited health-care resources. It is unclear why in comparison to the other AHT drug classes, AIIAs were associated with greatest persistence to AHT and better chance to start a new course of AHT after discontinuing.…”

Section: Discussionmentioning

confidence: 75%

“…Individuals not covered by Saskatchewan Health include those with federally funded health care such as members of the Royal Canadian Mounted Police, Canadian Forces and Registered Indians, who totally represent around 7% of the population). 26,27 Eligible for cohort entry were subjects with a diagnosis of hypertension (International Classification of Diseases-9 codes 401-404) 28 recorded in the physician services or hospital separation files between January 1, 1994 and September 30, 1999; aged 18-80 years; newly dispensed AHT between January 1, 1997 and September 30, 1999 (no AHT prescription 12 months prior to the first dispensing date, labelled here as treatment initiation); and initiating therapy with one of the five major antihypertensive drug classes, that is, AIIAs, ACEIs, BBs, CCBs or diuretics. Patients dispensed more than one agent at treatment initiation were excluded due to the difficulty arising in disentangling combination therapies to stockpiling.…”

Section: Study Subjectsmentioning

confidence: 99%

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Persistence and discontinuation patterns of antihypertensive therapy among newly treated patients: a population-based study

et al. 2005

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The objective was to assess persistence with antihypertensive therapy (AHT) and discontinuation patterns in patients newly dispensed different antihypertensive drug classes in a natural Canadian population-based setting. Hypertensive patients initiating AHT monotherapy were included in this 3-year retrospective cohort study (N ¼ 21 326) using the Saskatchewan health-care databases. Persistence was defined as consistently refilling a new prescription for AHT within 90 days of a previous dispensing. New courses of AHT were also documented in nonpersistent patients. Kaplan-Meier and Cox regression analyses were used to compare persistence and new courses of therapy across initial drugs. Compared to the newer angiotensin II antagonists (AIIAs), the likelihood of discontinuing therapy over the 39-month study period was significantly higher for angiotensin-converting enzymes inhibitors (HR ¼ 1.29; 95% CI ¼ 1.16-1.43), calcium channel blockers (HR ¼ 1.42; 95% CI ¼ 1.27-1.60), beta blockers (HR ¼ 1.62; 95% CI ¼ 1.45-1.80) and diuretics (HR ¼ 1.92; 95% CI ¼ 1.73-2.14). In the year following treatment discontinuation, between 54 and 75% of patients initiated a second course of treatment. Patients initiated on an AIIA had a significantly higher likelihood of starting a new course of therapy after a first treatment discontinuation, compared to all other agents. In conclusion, hypertensive patients initiated on an AIIA not only had greater persistence to AHT but were also more likely to initiate a new course of AHT after discontinuation than those initiating treatment with other agents. Further studies are required that relate intermittent treatment behaviours to health outcomes and costs in hypertension.

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Section: Discussionmentioning

confidence: 75%

Section: Study Subjectsmentioning

confidence: 99%

Persistence and discontinuation patterns of antihypertensive therapy among newly treated patients: a population-based study

et al. 2005

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“…Also use of population-based data limited the potential for selection bias. The study included all cases of prostate cancer identified by the Saskatchewan Cancer Agency registry, a population-based cancer registry known for its high levels of registration completeness and pathological confirmation 20,21 and a random sample of controls from the same source population. The very large sample size provided reasonably precise estimates for the effects of antidepressant use and permitted the examination of the effect of timing of use.…”

Section: Discussionmentioning

confidence: 99%

Antidepressants and risk of prostate cancer: a nested case – control study

Mahmud

et al. 2007

Prostate Cancer Prostatic Dis

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Although the association between antidepressant drug use and risk of cancer has received considerable attention in the past years, no work has been done specifically on prostate cancer. We carried out a population-based case -control study to assess the risk of prostate cancer in association with exposure to tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). 7767 prostate cancer cases diagnosed between 1981 and 2000 were accrued through the Saskatchewan Cancer Agency. Saskatchewan Health identified a total of 31 068 male controls who were matched on age and calendar time. Data on exposure to TCAs and SSRIs were compiled from the Saskatchewan outpatient prescription drug database, and covered a period upto 24 years. A positive significant association was found between TCA use and risk of prostate cancer, when exposure took place 2-5 years before diagnosis, with rate ratios of 1.31, 1.58, and 2.42 at the low, medium and high average daily dose levels, respectively. Exposure to SSRIs was not found to be significantly associated with the risk of prostate cancer. TCA use 2-5 years in the past was associated with a small dose-dependent increase in the risk of prostate cancer. Nevertheless, detection bias could have contributed to the observed association.

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“…Lifetime cost-effectiveness ratios in terms of cost per life-year gained and cost per QALY gained were predicted from in-trial estimates of incremental costs, event rates (death), and estimates of lost life expectancy associated with those in-trial deaths obtained from 3 sources: the Framingham Heart Study, 12,15 the Saskatchewan Health database, 16 and the Worcester Heart Attack Registry. 17,18 These 3 sources were used to estimate survival because no single source perfectly met these criteria.…”

Section: Economic Analysis and Costsmentioning

confidence: 99%

Cost-Effectiveness of Eplerenone Compared With Placebo in Patients With Myocardial Infarction Complicated by Left Ventricular Dysfunction and Heart Failure

Weintraub

Zhang²,

Mahoney³

et al. 2005

Circulation

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Background-In the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHE-SUS), aldosterone blockade with eplerenone decreased mortality in patients with left ventricular systolic dysfunction and heart failure after acute myocardial infarction. The present study was performed to evaluate the cost-effectiveness of eplerenone compared with placebo in these patients. Methods and Results-A total of 6632 patients with left ventricular systolic dysfunction and heart failure after acute myocardial infarction were randomized to eplerenone or placebo and followed up for a mean of 16 months. The coprimary end points were all-cause mortality and the composite of cardiovascular mortality/cardiovascular hospitalization. The evaluation of resource use included hospitalizations, outpatient services, and medications. Eplerenone was priced at the average wholesale price, $3.60 per day. Survival beyond the trial period was estimated from data from the Framingham Heart Study, the Saskatchewan Health database, and the Worcester Heart Attack Registry. The incremental cost-effectiveness of eplerenone in cost per life-year and quality-adjusted life-year gained compared with placebo was estimated. The number of life-years gained with eplerenone was 0.

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Health Databases in Saskatchewan

Cited by 89 publications

References 0 publications

Persistence and discontinuation patterns of antihypertensive therapy among newly treated patients: a population-based study

Persistence and discontinuation patterns of antihypertensive therapy among newly treated patients: a population-based study

Antidepressants and risk of prostate cancer: a nested case – control study

Cost-Effectiveness of Eplerenone Compared With Placebo in Patients With Myocardial Infarction Complicated by Left Ventricular Dysfunction and Heart Failure

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