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Co-prescription patterns of cardiovascular preventive treatments: a cross-sectional study in the Aragon worker’ health study (Spain)
  1. Isabel Aguilar-Palacio1,2,
  2. Sara Malo1,2,
  3. MªJesús Lallana2,3,
  4. Cristina Feja2,
  5. Juan González4,
  6. Belén Moreno-Franco1,5,
  7. MªJosé Rabanaque1,2
  1. 1Microbiology, Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain
  2. 2Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain
  3. 3Primary Health Care, Aragon Health Service, Zaragoza, Spain
  4. 4Biocomputing Unit. Health Services and Policy Research Group (ARiHSP), Institute of Health Sciences in Aragon (IACS), Zaragoza, Spain
  5. 5Unidad de Investigación en Prevención Cardiovascular, Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain
  1. Correspondence to Dr Isabel Aguilar-Palacio; iaguilar{at}unizar.es

Abstract

Objectives To identify cardiovascular disease (CVD) preventive treatments combinations, among them and with other drugs, and to determine their prevalence in a cohort of Spanish workers.

Design Cross-sectional study.

Setting Aragon Workers’ Health Study (AWHS) cohort in Spain.

Participants 5577 workers belonging to AWHS cohort. From these subjects, we selected those that had, at least, three prescriptions of the same therapeutic subgroup in 2014 (n=4605).

Primary and secondary outcome measures Drug consumption was obtained from the Aragon Pharmaceutical Consumption Registry (Farmasalud). In order to know treatment utilisation, prevalence analyses were conducted. Frequent item set mining techniques were applied to identify drugs co-prescription patterns. All the results were stratified by sex and age.

Results 42.3% of men and 18.8% of women in the cohort received, at least, three prescriptions of a CVD preventive treatment in 2014. The most prescribed CVD treatment were antihypertensives (men: 28.2%, women 9.2%). The most frequent association observed among CVD preventive treatment was agents acting on the renin-angiotensin system and lipid-lowering drugs (5.1% of treated subjects). Co-prescription increased with age, especially after 50 years old, both in frequency and number of associations, and was higher in men. Regarding the association between CVD preventive treatments and other drugs, the most frequent pattern observed was lipid-lowering drugs and drugs used for acid related disorders (4.2% of treated subjects).

Conclusions There is an important number of co-prescription patterns that involve CVD preventive treatments. These patterns increase with age and are more frequent in men. Mining techniques are a useful tool to identify pharmacological patterns that are not evident in the individual clinical practice, in order to improve drug prescription appropriateness.

  • cardiovascular epidemiology
  • pharmaco-prevention
  • mining technique

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors IA-P, SM and MJR designed the study. CF was in charge of database management and JG performed the statistical analyses. MJL and BM reviewed the bibliography. IA-P wrote the first draft of the manuscript. Finally, all the authors reviewed the manuscript and approved its final version.

  • Funding This work was supported by the Spanish Ministry of Health, Investigation of Sanitary Funding (Spain). Grant number PI13/01668 and PI17/01704. Also, GRISSA group, ARiHSP group and Unidad de Prevención Cardiovascular are co-funded by the Aragon Regional Governemnt Fund as reference group (codes B09_17R, B02_17R and B12_17R respectively).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

  • Patient consent for publication Obtained.

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