The effect of screening for cardio-renal risk factors on drug use in the general population.
OBJECTIVE
To evaluate the effect of a cardio-renal screening programme on desired and undue drug use.


METHODS
Data from the PREVEND cohort (Prevention of REnal and Vascular ENd-stage Disease) were used. The drug use of screened (randomly) selected subjects (n = 2650) was compared with unscreened subjects, matched for age and sex (n = 10 434). Drug use in the overall PREVEND cohort, enriched for albuminuria (n = 6751), was also studied. Screening-related drugs (antihypertensive, antilipidaemic, antidiabetic and antithrombotic) were selected, as well as screening-unrelated drugs (benzodiazepines, drugs for acid-related disorders and painkillers). Time to first prescription after screening is presented as Kaplan-Meier curves.


RESULTS
After 6.5 years of follow-up, the incidence of drug use was not significantly different between the screened, randomly selected and unscreened cohorts. Antihypertensives were used by 21.5 and 20.8%, respectively; antilipidaemic 12.8 and 10.2%, antidiabetics 4.0 and 3.9%, and antithrombotic 11.4 and 12.0%. Screening-unrelated drugs were used at comparable frequencies. Compared with the unscreened cohort, screening-related drugs were prescribed more frequently for subjects in the enriched cohort (25.8, 15.5, 5.5 and 13.5% for antihypertensive, antilipidaemic, antidiabetic and antithrombotic, respectively), whereas screening-unrelated drugs were used at comparable frequencies.


CONCLUSIONS
The incidence of drug use did not differ between the screened, randomly selected and unscreened cohorts. Screening does not lead to more drug prescription, thus arguing against the fear of undue medicalization after screening. The data also show that, for screening to be successful, it should be performed in a targeted population, such as one enriched for albuminuria.
Atthobari
Jarir
J
Department of Social Pharmacy, Pharmacoepidemiology & Pharmacotherapy, Groningen University for Drug Exploration (GUIDE), University of Groningen, Groningen, The Netherlands.
Gansevoort
Ron T
RT
Visser
Sipke T
ST
de Jong
Paul E
PE
de Jong-van den Berg
Lolkje T W
LT
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000188:drug therapy; D015331:Cohort Studies; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000502:physiology; D007674:Kidney Diseases / Q000139:chemically induced / Q000188:drug therapy; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D011159:Population Surveillance; D012307:Risk Factors
D004364:Pharmaceutical Preparations