Hospital Admissions Due to Ischemic Heart Diseases and Prescriptions of Cardiovascular Diseases Medications in England and Wales in the Past Two Decades

Abstract

Objectives: The aim of this study was to explore the trend of ischemic heart disease (IHD) admission and the prescriptions of IHD medications in England and Wales. Methods: A secular trends study was conducted during the period of 1999 to 2019. We extracted hospital admission data for patients from all age groups from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Prescriptions of IHD medications were extracted from the Prescription Cost Analysis database from 2004 to 2019. The chi-squared test was used to assess the difference between the admission rates and the difference between IHD medication prescription rates. The trends in IHD-related hospital admission and IHD-related medication prescription were assessed using a Poisson model. The correlation between hospital admissions for IHD and its IHD medication-related prescriptions was assessed using the Pearson correlation coefficient. Results: Our study detected a significant increase in the rate of cardiovascular disease (CVD) medication prescriptions in England and Wales, representing a rise in the CVD medications prescription rate of 41.8% (from 539,334.95 (95% CI = 539,286.30–539,383.59) in 2004 to 764,584.55 (95% CI = 764,545.55–764,623.56) in 2019 prescriptions per 100,000 persons), with a mean increase of 2.8% per year during the past 15 years. This increase was connected with a reduction in the IHD hospital admission rate by 15.4% (from 838.50 (95% CI = 836.05–840.94) in 2004 to 709.78 (95% CI = 707.65–711.92) in 2019 per 100,000 persons, trend test, p < 0.01), with a mean decrease of 1.02% per year during the past 15 years and by 5% (from 747.43 (95% CI = 745.09–749.77) in 1999 to 709.78 (95% CI = 707.65–711.92) in 2019 per 100,000 persons, trend test, p < 0.01) with a mean decrease of 0.25% per year during the past two decades in England and Wales. Conclusion: The rate of hospitalisation due to IHD has decreased in England and Wales during the past two decades. Hospitalisation due to IHD was strongly and negatively correlated with the increase in the rates of dispensing of IHD-related medications. Other factors contributing to this decline could be the increase in controlling IHD risk factors during the past few years. Future studies exploring other risk factors that are associated with IHD hospitalisation are warranted.

Drugs utilization profile in England and Wales in the past 15 years: a secular trend analysis

“…Previous studies in Denmark, Sweden, and Norway explored the utilisation pattern of different classes of medications such as opioids and antiarrhythmic medications and reported an increase in their utilisation [ 33 – 35 ]. Recent studies in the UK showed an increase in hospitalizations for various acute and chronic conditions, such as viral diseases, respiratory diseases, and heart diseases [ 19 , 36 , 37 ]. Raised hospitalisation rates highlight that there is an increase in the prevalence of these diseases that lead to hospitalisation, which itself could lead to an increase in the prescribing pattern of medications.…”

“…A previous study by Hemmo et al has explored the hospitalisation pattern for ischemic heart diseases (IHD)s and the prescription pattern for CVD medication for the period between 1999 and 2019 [ 19 ]. Their study found that the prescription rate for beta-blockers, calcium channel blockers, anti-platelets, and lipid-lowering medications, was negatively correlated with IHD-related hospital admission rates [ 19 ]. The prescription rate for these medications increased as they are mainly maintenance therapy and have been shown to improve symptoms and prolong survival [ 46 – 50 ].…”

Trends of Hospital Admissions Due to Congenital Anomalies in England and Wales between 1999 and 2019: An Ecological Study

“…This was an ecological study using publicly available data extracted from the Hospital Episode Statistics (HES) database in England [16] and the Patient Episode Database for Wales (PEDW) for the period between April 1999 and April 2019 [17]. They have been used previously to explore the trends of different health outcomes and the associated hospital admissions [18][19][20][21]. The hospital episode statistics database and patient episode database for Wales record all hospital admissions, outpatients and accident and emergency (A&E) activities performed at all NHS trusts and any independent sector funded by NHS trusts.…”

Hospital Admission Trends Due to Viral Infections Characterised by Skin and Mucous Membrane Lesions in the Past Two Decades in England and Wales: An Ecological Study

“…This was an ecological study using data extracted from the Hospital Episode Statistics (HES) database in England [ 17 ] and the Patient Episode Database for Wales (PEDW) for the period between April 1999 and April 2019 [ 18 ]. They have been used previously to explore the trends of different health outcomes and the associated hospital admissions [ 19 , 20 ]. The HES and PEDW databases contain hospital admission data for patients with viral infections characterized by skin and mucous membrane lesions from all age groups, which are subdivided into four categories; below 15 years, 15–59 years, 60–74 years, and 75 years and above.…”