High prevalence of diagnosis of diabetes, depression, anxiety, hypertension, asthma and COPD in the total population of Stockholm, Sweden – a challenge for public health

Abstract

BackgroundThere is limited knowledge on the prevalence of disease in total populations. Such studies have historically been difficult to conduct but the development of health data registers has facilitated large-scale studies on recorded diagnoses in entire regions. The aim of this study was to analyze the prevalence of diagnosis of six common diseases in the Swedish capital region.MethodsThe study population included all living persons who resided in Stockholm County, Sweden, on December 31st 2011 (N = 2 093 717). Information on all consultations between 2007 and 2011 was obtained from primary health care, specialist outpatient care and inpatient care. Prevalence was defined as the proportion of individuals with a recorded diagnosis of diabetes, depression, anxiety disorders, hypertension, asthma and chronic obstructive pulmonary disease during the five year period, respectively. Analyses were done by age and gender.ResultsHypertension had the highest five-year prevalence (12.2%), followed by depression (6.6%), diabetes mellitus (6.2%), asthma (5.9%), anxiety disorders/phobia (4.8%), and COPD (1.8%). Diabetes was more common in men (5.3% of women and 7.1% of men) while depression (8.7% in women and 4.4% in men) and anxiety (6.3% in women and 3.4% in men) were considerably more common in women. Smaller gender differences were also found for hypertension (13.0% in women and 11.4% in men), asthma (6.4% in women and 5.4% in men) and COPD (2.1% in women and 1.6% in men). Diabetes, hypertension and COPD increased markedly with age, whereas anxiety, depression and asthma were fairly constant in individuals above 18 years. During one year of observation, more than half of all patients had only been diagnosed in primary health care, with hypertension being the diagnosis with the largest proportion of patients only identified in primary health care (70.6%).ConclusionThe prevalence of common diseases in the population can be estimated by combining data gathered during consecutive years from primary care, specialist outpatient care and inpatient care. However, accuracy of disease prevalence is highly dependent on the quality of the data. The high prevalence of the six diagnoses analysed in this study calls for preventive action to minimize suffering and costs to society.

The First Decade with the Swedish Prescribed Drug Register – A Systematic Review of the Output in the Scientific Literature

“…[18] were registered as coming from these sources. As medical records include extensive health information, linkage to this data source was recorded separately [19].…”

“…hospital admission and discharge dates, diagnoses and procedures [11], Cause of death register [12], Medical birth register [13], Cancer register [14]). Data retrieved from Statistics Sweden administering civic information including, for example migration [15] and socio-economic characteristics [16], healthcare quality registers focusing on certain conditions or procedures [17] or regional databases with detailed administrative information on healthcare consumption [18] were registered as coming from these sources. As medical records include extensive health information, linkage to this data source was recorded separately [19].…”

Monografia Giovani FADOI: dalle evidenze alla pratica clinica

“…La letteratura suggerisce in modo generico una raccolta attenta dell'anamnesi, volta a far luce su possibili limitazioni funzionali, insorgenza di sintomi, un esame obiettivo che comprenda la misurazione del peso corporeo, della circonferenza vita e del body mass index (BMI), l'esecuzione degli esami di laboratorio di primo livello in accordo anche con quanto valutato durante la visita. 6,17,147,151 Si dovrebbe inoltre considerare l'aderenza ai farmaci e allo stile di vita corretto, l'insorgenza di effetti collaterali, il controllo dei fattori di rischio cardiovascolare e delle comorbidità, l'insorgenza di sintomi e segni suggestivi di scompenso cardiaco, la ricorrenza di ischemia, l'insorgenza di aritmie, di valvulopatie o malattia vascolare periferica. Le linee guida americane suggeriscono il SAQ (Seattle Angina Questionnaire, un questionario con 19 temi, volto alla identificazione di sintomi, limitazione funzionale e qualità di vita del paziente con CI stabile) come utile strumento per il monitoraggio dello stato clinico del paziente.…”

“…Questa soglia può essere indicativa nell'anziano (149) e meno nel giovane adulto (150). Non ci sono evidenze per lo screening con la spirometria dei soggetti asintomatici (151). Inoltre soggetti asintomatici con lieve limitazione delle vie aeree possono non avere una minore qualità di vita rispetto ai soggetti con normale funzione polmonare (152).…”

An official American Thoracic Society/European Respiratory Society statement: research questions in COPD

“…There is evidence that screening detects undiagnosed COPD [18]. However, asymptomatic individuals with mild airflow limitation (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 1) may not have faster lung function decline or a lower quality of life than asymptomatic individuals with normal lung function [19], and there are no data showing that outcomes improve among individuals who are identified as having COPD before developing symptoms, that early treatment provides any benefit in asymptomatic individuals, or that screening is cost effective [20].…”