title: Patient educational level and use of newly marketed drugs: a register-based study of over 600,000 older people.
abstract: OBJECTIVE
  To examine the association between educational level and the use of newly marketed drugs (NMD) among elderly persons.
  
  
  METHODS
  We conducted a register-based, retrospective, cross-sectional study of 626,258 people aged 75-89 years who filled at least one drug prescription from August to October 2005 and who, consequently, were registered in the Swedish Prescribed Drug Register (SPDR). Data from the SPDR were record-linked to the Swedish National Inpatient Register and the Education Register. Newly marketed drugs were defined as new chemical entities that had been approved in Sweden between 2000 and 2004.
  
  
  RESULTS
  Overall, NMD were prescribed to 7.3% of the study population. The use of NMD increased with increasing educational level (6.9% for the lowest educated elderly and 8.1% for the highest educated elderly), and education was associated with NMD [odds ratio (OR) 0.82; 95% confidence interval (CI)] 0.80-0.88 for <9 compared with > or =13 years of education) after adjustment for age, sex, type of residential area and number of dispensed drugs. Decreasing educational level was associated with a lower probability of using most of the NMD, especially oseltamivir (adjusted OR 0.16; 95% CI 0.12-0.22 for <9 years of education compared with > or =13 years of education) and ezetimibe.
  
  
  CONCLUSIONS
  This study suggests that education-related inequalities in NMD use may exist even in a healthcare system that claims to ensure a high degree of equity. Future research is required to explain why educational level influences the selection of new drugs and whether it has any impact on health outcomes.
authors.affiliation: Aging Research Center, Karolinska Institutet, Gävlegatan 16, 11330 Stockholm, Sweden. Imran.Haider@ki.se
authors.forename: Syed Imran
authors.initials: SI
authors.lastname: Haider
authors.forename: Kristina
authors.initials: K
authors.lastname: Johnell
authors.forename: Gunilla
authors.initials: G
authors.lastname: Ringbäck Weitoft
authors.forename: Mats
authors.initials: M
authors.lastname: Thorslund
authors.forename: Johan
authors.initials: J
authors.lastname: Fastbom
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D017723:Drug Utilization Review; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008389:Marketing of Health Services; D010353:Patient Education as Topic; D055553:Prescription Drugs / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D012042:Registries; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013548:Sweden
chemical_list: D055553:Prescription Drugs